Individual provider Active NPI

Tin M DO, M.D.

  • Emergency Medicine Physician
  • San Francisco, CA
National Provider Identifier
1154419034
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A84566 Issued in CA
Practice address
495 Stanyan St
San Francisco, CA 94117
Phone
(415) 750-5700
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A84566 CA Primary

Addresses

Primary practice location

495 Stanyan St
San Francisco, CA 94117

Mailing address

2100 Powell St
Suite 920
Emeryville, CA 94608-1826
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
00A845660MedicaidCA

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
I20060130000916 CA Practitioner - Emergency Medicine 8426062399 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Geffen School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - CaliforniaGroup PAC ID 6103739131, shared by 2 NPIs, 1,278 clinicians

Practice addresses (Care Compare)

250 S Grand Ave
Glendora, CA 91741-4218
Phone (626) 963-8411

7500 Hospital Dr
Sacramento, CA 95823-5403
Phone (916) 423-3000

Hospital & facility affiliations

  • El Camino Health Hospital, Mountain View, CA, CCN 050308

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A84566CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine CurrentSince May 4, 2007 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 2015 Accepting new patients
Cep America-California Emergency Medicine CurrentSince May 4, 2007 Accepting new patients
California Emergency Physician Medical Group Past Accepting new patients
Sierra Rural Physicians, Inc. Emergency Medicine Past Accepting new patients
Central California Radiology Associates Inc Past Accepting new patients

Locations

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

3901 Lone Tree Way
Antioch, CA 94509
Phone (925) 779-7200

751 Medical Center Ct
#1182
Chula Vista, CA 91911

1900 Sullivan Ave
Daly City, CA 94015
Phone (650) 991-6503

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

9920 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 236-4000

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2500 Grant Rd
Mountain View, CA 94040
Phone (650) 903-9500

180 Rowland Way
Novato, CA 94945
Phone (415) 209-1300

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

768 Mountain Ranch Rd
San Andreas, CA 95249
Phone (209) 464-6422

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

450 Stanyan St
San Francisco, CA 94117
Phone (415) 668-1000

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Interoperability endpoints

  • Direct secure messaging: tin.do.2@25843.direct.athenahealth.com
  • Direct secure messaging: tdo117965@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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 3

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1154419034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST",
            "address_2": "SUITE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081826",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 STANYAN ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94117",
            "telephone_number": "415-750-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "TIN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A84566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A845660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.