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IMPACT MEDICAL ASSOCIATES CALIFORNIA
NPI 1609501006
Family Medicine in San Diego, CA

Active since July 19, 2022
11838 BERNARDO PLAZA CT STE 260A, SAN DIEGO, CA 92128(858) 487-8778(858) 487-2738 Get Directions Write a Review

NPPES record last updated: April 13, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 13, 2026, Jul 19, 2022 (2 updates tracked since 2022).

About Impact Medical Associates California NPPES

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

IMPACT MEDICAL ASSOCIATES CALIFORNIA (NPI 1609501006) is a healthcare organization registered as a family medicine in San Diego, California and active in the NPI registry since July 2022. The organization lists Michael Connelly, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1609501006
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameIMPACT MEDICAL ASSOCIATES CALIFORNIA
Location Address11838 BERNARDO PLAZA CT STE 260ASan Diego, CA 92128-2413
Mailing Address5355 Avenida Encinas Ste 103Carlsbad, CA 92008-4332 · (584) 878-7788 · Fax (858) 487-2738
Phone(858) 487-8778
Fax(858) 487-2738
Organization SubpartNo
Authorized OfficialMichael ConnellyManaging Partner · (714) 905-9503
Enumeration DateJuly 19, 2022
Last NPPES UpdateApril 13, 20262 updates tracked since enumeration
NPPES CertifiedApril 13, 2026
✔ NPI 1609501006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
11838 BERNARDO PLAZA CT STE 260A, San Diego, CA 92128
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Impact Medical Associates California is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Impact Medical Associates California, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (5)

Jose Castrejon, MD
Family Practice
NPI 1568486710
2023 W VISTA WAY STE K
Vista, CA 92083
(760) 806-1406
✔ PECOS17 mi
Airene Maldonado
Nurse Practitioner
NPI 1245972835
26501 MESA VISTA DRIVE
Menifee, CA 92584
(626) 290-4548
✔ PECOS✔ Accepts Medicare45 mi
Mary Nganga, NP
Nurse Practitioner
NPI 1578920880
1875 S GRANT ST STE 760
San Mateo, CA 94402
(888) 227-8884
✔ PECOS✔ Accepts Medicare430 mi
Jocelyn Montierth, MSN, APRN, AGPCNP-BC
Nurse Practitioner
NPI 1003409756
375 N MAIN ST STE 103
Kaysville, UT 84037
(801) 216-4130
✔ PECOS✔ Accepts Medicare621 mi
Amy Fowers, FNP
Nurse Practitioner
NPI 1407432933
4460 STONE CREEK RD UNIT B
West Haven, UT 84401
(801) 781-0798
✔ PECOS✔ Accepts Medicare627 mi

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

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 Impact Medical Associates California's NPI number?

The NPI number for Impact Medical Associates California is 1609501006. It was assigned to this organization in the NPPES registry on July 19, 2022.

Where is Impact Medical Associates California located?

Impact Medical Associates California is located at 11838 Bernardo Plaza Ct Ste 260A, San Diego, CA 92128. The listed phone number is (858) 487-8778.

What is Impact Medical Associates California's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Impact Medical Associates California enrolled in Medicare?

Yes. Impact Medical Associates California is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Impact Medical Associates California?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Impact Medical Associates California. A 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 the clinician's services. The largest specialties are Nurse Practitioner (4) and Family Practice (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Impact Medical Associates California was last updated on April 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.