DR. JOHN F SHEGA M.D.
NPI 1366432312
Dermatology in San Diego, CA
NPI Status: Active since October 21, 2005
Contact Information
2710 HEALTH CENTER DR
SAN DIEGO, CA
ZIP 92123
Phone: (858) 292-7525
- Individual
- Male
- Years of Experience 48
- Dermatology
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
- CLIA Number: 05D0685820
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-31-2025
About JOHN SHEGA
This page provides the complete NPI Profile along with additional information for John Shega, a provider established in San Diego, California with a medical specialization in Dermatology and more than 48 years of experience. He graduated from Washington University School Of Medicine in 1978. The healthcare provider is registered in the NPI registry with number 1366432312 assigned on October 2005. The practitioner's primary taxonomy code is 207N00000X with license number G40700 (CA). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1366432312
- Provider Name
- DR. JOHN F SHEGA M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2710 HEALTH CENTER DR SAN DIEGO, CA 92123
- Location Phone
- (858) 292-7525
- Mailing Address
- 2710 HEALTH CENTER DR SAN DIEGO, CA 92123
- Mailing Phone
- (858) 292-7525
- Medical School Name
- WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 1978
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-21-2005
- Last Update Date
- 04-07-2016
- Code Navigator
A dermatologist like John Shega is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G40700
- License State
- CA
- Taxonomy Description
- A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 174400000X | Other Service Providers | Specialist | G40700 (CA) |
| 2 | 207ND0101X | Allopathic & Osteopathic Physicians | Dermatology | G40700 (CA) |
| 3 | 207NI0002X | Allopathic & Osteopathic Physicians | Dermatology | G40700 (CA) |
| 4 | 207NS0135X | Allopathic & Osteopathic Physicians | Dermatology | G40700 (CA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| G40700 | MEDICARE ID-TYPE UNSPECIFIED (04) | CA | |
| A48321 | MEDICARE UPIN (02) | CA |
Medicare Participation & PECOS Enrollment Status
John Shega is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
John Shega is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7810024528
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20100428000429
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy of related skin growth, each additional growth
Biopsy of related skin growth, first growth
Destruction of precancer skin growth, 15 or more growths
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Full thickness skin graft to scalp, arms, or legs, 20.0 sq cm or less
Fungal culture (mold or yeast) of skin, hair, or nail
Injection into skin growth, more than 7 growths
Injection of drug or substance under skin or into muscle
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Melanoma (skin cancer) excision
New patient office or other outpatient visit, 45-59 minutes
Pathology examination of tissue using a microscope, intermediate complexity
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks
Therapy procedure using ultraviolet radiation with tar or petroleum jelly application
Tissue fungi or parasites
A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.
This service was performed 34 times for 29 patientsA biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
This service was performed 136 times for 72 patientsThis procedure involves removing 15 or more precancerous skin growths to prevent them from developing into cancer. It's done using various methods like freezing, creams, or minor surgery. The goal is to protect your health by stopping cancer before it starts.
This service was performed 296 times for 75 patientsThis is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
This service was performed 29 times for 22 patientsThis is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
This service was performed 762 times for 104 patientsA full-thickness skin graft involves transferring a layer of skin from one area of the body to the scalp, arms, or legs. This procedure, covering an area 20.0 sq cm or less, aids in healing wounds or areas with skin loss. It's a safe, common surgical practice.
This service was performed 13 times for 13 patientsA fungal culture is a test to detect and identify fungi in skin, hair, or nails. It helps diagnose conditions like ringworm or athlete's foot. A small sample is taken and sent to a lab, where it's placed in conditions that allow any fungi present to grow. This helps in determining the right treatment.
This service was performed 14 times for 14 patientsThis procedure involves injecting medication into multiple skin growths (more than 7) to either shrink them or eliminate them. It's a safe, minimally invasive method often used for benign growths. Comfort during the process is ensured.
This service was performed 35 times for 11 patientsThis procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
This service was performed 47 times for 21 patientsTriamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
This service was performed 128 times for 27 patientsMelanoma excision is a procedure where a surgeon removes melanoma, a type of skin cancer, and some surrounding healthy tissue. Local anesthesia is applied to numb the area. The goal is to completely remove the cancer and prevent its spread. Healing time varies.
This service was performed for 25 patientsThis is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
This service was performed 29 times for 29 patientsA pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
This service was performed 204 times for 75 patientsThis procedure involves the careful removal of a growth from the head, neck, hands, or feet. The removed tissue, divided into 1-5 blocks, is then examined under a microscope to study its characteristics and determine the nature of the growth.
This service was performed 20 times for 13 patientsThis procedure involves the careful removal of abnormal growths from the head, neck, hands, or feet. The removed tissues, divided into 1-5 blocks, are then examined under a microscope to identify any irregularities. The process may be carried out in multiple stages for thorough examination.
This service was performed 47 times for 13 patientsThis therapy involves applying tar or petroleum jelly on the skin, followed by exposure to ultraviolet radiation. It helps in treating skin conditions by slowing cell growth and reducing inflammation. It's a safe, controlled process, often used for conditions like psoriasis.
This service was performed 294 times for 24 patientsTissue fungi or parasites refer to microorganisms that can infect various parts of the body. This may cause symptoms like fatigue, fever, and skin changes. Diagnosis involves testing samples from the affected area. Treatment often includes medication to eliminate the infection.
This service was performed 15 times for 15 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.71 for a new patient copayment and $19.21 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 92123 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $94.87
- Minimum New Patient Price $62.1
- Maximum New Patient Price $184.71
- Average New Patient Copayment $23.71
- Minimum New Patient Copayment $15.52
- Maximum New Patient Copayment $46.17
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $76.87
- Minimum Established Patient Price $20.62
- Maximum Established Patient Price $151.42
- Average Established Patient Copayment $19.21
- Minimum Established Patient Copayment $5.15
- Maximum Established Patient Copayment $37.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Documentation of Current Medications in the Medical Record | 15% | 5667 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 99% | 544 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Pain Assessment and Follow-Up | 23% | 5667 |
| Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present | ||
| Patient-Specific Education | 40% | 458 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
| Provide Patient Access | 40% | 458 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0685820
- Facility Type
- Physician Office
- Certificate Effective Date
- April 30, 2022
- Certificate Expiration Date
- October 31, 2025
- Laboratory Director
- JOHN F. SHEGA MD
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to John Shega after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366432312, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366432312, enumerated as an "individual" on October 21, 2005.
The provider is located at 2710 HEALTH CENTER DR SAN DIEGO, CA 92123 and the phone number is (858) 292-7525.
Dermatology with taxonomy code 207N00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
