NICOLE MAE KETRING AYSON (M.D.) – Pediatrics Physician, NPI 1013278704
Pediatrics Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
21,558 INTERNAL MEDICINE in CA
Provider Addresses for NICOLE MAE KETRING AYSON (M.D.)
1550 Broadway Ste 2
San Diego, CA 921015713
Phone: (619) 515-2525
Type: Location
3020 CHILDRENS WAY
MC 5003
SAN DIEGO, CA 921234223
Phone: (858) 309-6300
Type: Mailing
3665 KEARNY VILLA RD STE 501
SAN DIEGO, CA 921231953
Phone: (858) 966-5803
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-08-26
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160826001584 | I | Internal Medicine | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92101)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | CA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NV | |
| Family Practice | IL | |
| Family Practice | CA | |
| Sports Medicine, Physical Medicine And Rehabilitation | CA | |
| Physician Assistant | TX | |
| P S Y C H I A T R Y | NJ | |
| - | CA | |
| - | MA | |
| - | CA |
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