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MONICA MAE VIDAURRAZAGA MD
NPI 1346628310
Internal Medicine in San Diego, CA

Active since May 11, 2015PECOS Enrolled
4094 4TH AVE, SAN DIEGO, CA 92103(619) 515-2545(619) 501-9645 Get Directions Write a Review

NPPES record last updated: November 18, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Monica Mae Vidaurrazaga Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MONICA MAE VIDAURRAZAGA MD (NPI 1346628310) is an individual internal medicine provider in San Diego, California, licensed in California (A169207) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Brooklyn.

NPPES Registry Identity

NPI1346628310
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameMONICA MAE VIDAURRAZAGACredential: MD
Location Address4094 4TH AVESan Diego, CA 92103-2143
Mailing Address823 Gateway Center WaySan Diego, CA 92102-4541 · (619) 515-2300
Phone(619) 515-2545
Fax(619) 501-9645
Sole ProprietorNo
Enumeration DateMay 11, 2015
Last NPPES UpdateNovember 18, 2020
NPPES CertifiedSeptember 9, 2020
✔ NPI 1346628310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A169207
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4094 4TH AVE, San Diego, CA 92103
Open in Google Maps ↗

Secondary Practice Location 1

Location 1150 55th StBrooklyn, NY 11220-2508 · Phone (718) 630-6373

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Monica Mae Vidaurrazaga Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Monica Vidaurrazaga reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Health Centers Of San Diego Inc
Same address
Federally Qualified Health Center (FQHC)
4094 4TH AVE
San Diego, CA 92103
  • Reassigned Medicare billing, California enrollment
  • 1,100 clinicians in this Medicare group
NPI 1629456900 (619) 515-2545

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELENA HAPKE PT
Physical Therapist
4094 4TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545
JOEL FRANCIS TRAMBLEY MD
Internal Medicine
4094 4TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545
DR. JOE BENJAMIN FLORES MD
Family Medicine
4094 4TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545
DR. MICHAEL JOSEPH EVERTON M.D.
Radiology (Diagnostic Radiology)
4094 4TH AVE, SUITE 200, MC 0834
SAN DIEGO, CA 92103
San Diego County (312) 282-2638
KAYLA R TARRANT ASW
Social Worker (Clinical)
4094 4TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545
JENNIFER SAGUN ASUNCION LCSW
Social Worker (Clinical)
4094 4TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545
KAITLYN MAHONEY DPT
Physical Therapist
4094 4TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2300
ERNEST SUNG KIM MD
Family Medicine (Sports Medicine)
4094 4TH AVE
SAN DIEGO, CA 92103
San Diego County (619) 515-2545

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Monica Vidaurrazaga's NPI number?

The NPI number for Monica Vidaurrazaga is 1346628310. It was assigned to this individual provider in the NPPES registry on May 11, 2015.

Where is Monica Vidaurrazaga located?

Monica Vidaurrazaga practices at 4094 4th Ave, San Diego, CA 92103. The listed phone number is (619) 515-2545.

What is Monica Vidaurrazaga's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Monica Vidaurrazaga enrolled in Medicare?

Yes. Monica Vidaurrazaga is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Monica Vidaurrazaga's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Monica Vidaurrazaga reassigns Medicare benefits to Family Health Centers Of San Diego Inc (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Monica Vidaurrazaga's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Monica Vidaurrazaga was last updated on November 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.