Individual provider Active NPI

Elsa A. Tekle, M.D.

  • Anesthesiology Physician
  • Fountain Valley, CA
National Provider Identifier
1093799306
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A78066 Issued in CA
Practice address
17100 Euclid St
Fountain Valley, CA 92708-4004
Phone
(714) 949-1211
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A78066 CA Primary

Addresses

Primary practice location

17100 Euclid St
Fountain Valley, CA 92708-4004

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (800) 883-7243

Other identifiers 1

IdentifierTypeStateIssuer
00A780660MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907000553 CA Practitioner - Anesthesiology 7315979747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orange Coast Anesthesia IncGroup PAC ID 2466613591, 85 clinicians

Practice addresses (Care Compare)

17100 Euclid St
Fountain Valley, CA 92708-4004
Phone (714) 966-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Premiercare Anesthesia Fountain Valley Inc Anesthesiology CurrentSince Jun 14, 2014 Accepting new patients
Orange Coast Anesthesia Inc Anesthesiology CurrentSince Oct 31, 2023 Accepting new patients

Locations

17100 Euclid St
Fountain Vly, CA 92708
Phone (714) 966-7200

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1093799306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "800-883-7243",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 EUCLID ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084004",
            "telephone_number": "714-949-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKLE",
        "first_name": "ELSA",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A78066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A780660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.