Individual provider Active NPI

Hideaki Tanaka, MD

  • Emergency Medicine Physician
  • San Diego, CA
National Provider Identifier
1124280730
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A163007 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X A163007 CA
Emergency Medicine Physician 207P00000X A163007 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

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
I20190814002556 CA Practitioner - Emergency Medicine 9133359870 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leo Tanaka MD IncGroup PAC ID 4880076314, 2 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (619) 740-6000

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A163007CAMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jul 14, 2019 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Leo Tanaka MD Inc Undersea and Hyperbaric Medicine CurrentSince Jul 1, 2022 Accepting new patients
UC San Diego Health Community Group CurrentSince Jul 14, 2019 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Jul 14, 2019 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2019 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
El Centro Regional Medical Center Past Accepting new patients
Blue Job Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

9600 Cuyamaca St
Ste 201
Santee, CA 92071

Organizations & group practices 11

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1124280730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "HIDEAKI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "CA",
            "license": "A163007",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A163007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.