Tiffany Prachachalerm, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20A18914 Issued in CA

Practice address

1212 W. 17TH St.
Santa Ana, CA 92706

Phone

(714) 954-0432

Fax

(714) 796-6265

NPI assigned

Jun 11, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Internal Medicine

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorialcare Orange Coast Medical Center Hospital, Fountain Valley, CA, CCN 050678

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: tiffany.prachachalerm.p1@direct.aphcv.nextgenshare.com
• Direct secure messaging: tprachachalerm873018@direct.memorialcare.org

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.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Asian Pacific Health Care Venture, Inc.

  • Community Health Clinic/Center
  • Los Angeles, CA
  • NPI 1336208255
  Medicare reassignment NPD
• Menalam Health Services PC

  • Hospitalist Physician
  • Simi Valley, CA
  • NPI 1114594967
  Medicare reassignment NPD
• Asian Pacific Health Care Venture, Inc.

  • Community Health Clinic/Center
  • El Monte, CA
  • NPI 1609147743
  NPD
• Menalam Health Services PC

  • Diagnostic Radiology Physician
  • Glendora, CA
  • NPI 1003779596
  NPD
• Bristol Park Medical Group, Inc

  • Family Medicine Physician
  • Costa Mesa, CA
  • NPI 1043266760

  Internal Medicine

  NPD (past)

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

• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575
  Care Compare affiliation

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1104319565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 W. 17TH ST.",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92706",
            "telephone_number": "714-954-0432",
            "fax_number": "714-796-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W. 17TH ST.",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92706",
            "telephone_number": "714-954-0432",
            "fax_number": "714-796-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRACHACHALERM",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A18914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Darlene Jeannine Powell
• Dorothy A Powell
• Evan Nicole Powell, MSW
• Kathryn J Powell, OTR
• Power ABA of California
• Practice Diagnostics LLC
• Practice of Shahgaldian Dental Inc.
• Caridad Prado
• Cassandra Lisset Prado
• Irvin Prado

• Internal Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.