Individual provider Active NPI

Adel Rasmy Tawfilis, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • San Diego, CA
National Provider Identifier
1114037470
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
42008 Issued in CA
Practice address
12264 El Camino Real
Suite 111
San Diego, CA 92130-3058
Phone
(858) 509-1259
Fax
(858) 509-0912
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 42008 CA Primary

Addresses

Primary practice location

12264 El Camino Real
Suite 111
San Diego, CA 92130-3058

Mailing address

12264 El Camino Real
Suite 111
San Diego, CA 92130-3058
Phone (858) 509-1259

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000662 CA Practitioner - Oral Surgery 7618068917 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42008CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency and Acute Care Medical Corporation CurrentSince Sep 1, 2007 Accepting new patients
Scripps Health Current Accepting new patients
Tri-City Hospital Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Rady Children'S Hospital San Diego Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

12264 El Camino Real
Ste 111
San Diego, CA 92130
Phone (858) 509-1259

Interoperability endpoints

  • Direct secure messaging: atawfilis43214@scrippshlth.medalliesdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114037470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12264 EL CAMINO REAL",
            "address_2": "SUITE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303058",
            "telephone_number": "858-509-1259",
            "fax_number": "858-509-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12264 EL CAMINO REAL",
            "address_2": "SUITE 111",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921303058",
            "telephone_number": "858-509-1259",
            "fax_number": "858-509-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWFILIS",
        "first_name": "ADEL",
        "middle_name": "RASMY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "42008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.