Individual provider Active NPI

Tayson Delengocky, D.O

  • Retina Specialist (Ophthalmology) Physician
  • Chula Vista, CA
National Provider Identifier
1164637153
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
20A12784 Issued in CA
Practice address
835 3Rd Ave
Suite a
Chula Vista, CA 91911-1352
Phone
(619) 425-7755
Fax
(619) 425-2138
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036122962 IL
Ophthalmology Physician 207W00000X 20A12784 CA
Retina Specialist (Ophthalmology) Physician 207WX0107X 20A12784 CA Primary

Addresses

Primary practice location

835 3Rd Ave
Suite a
Chula Vista, CA 91911-1352

Mailing address

835 3Rd Ave
Suite a
Chula Vista, CA 91911-1352
Phone (619) 425-7755

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
I20130903000773 CA Practitioner - Ophthalmology 7012001191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of North Texas HSC, College of Osteopathic Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Retina Associates, LPGroup PAC ID 4284676966, 20 clinicians

Practice addresses (Care Compare)

1452 S la Brucherie Rd
A
El Centro, CA 92243-9676
Phone (760) 352-7755

1498 S la Brucherie Rd
Suite a
El Centro, CA 92243-9676
Phone (619) 425-7755

835 3Rd Ave
Suite a
Chula Vista, CA 91911-1352
Phone 6194257755257755

835 3Rd Ave a
Chula Vista, CA 91911-1352

Hospital & facility affiliations

  • El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036122962ILMDOphthalmology Physician

Practice roles (5 of 6)

OrganizationSpecialtyStatusNew patients
Bond Eye Associates, SC Ophthalmology PastSince Mar 1, 2006 Accepting new patients
Bond Eye Associates, S.C. Past Accepting new patients
El Centro Regional Medical Center Past Accepting new patients
South Texas Retina Consultants, LLP Ophthalmology PastSince Jun 2, 1997 Accepting new patients
Afsaneh Amini, O.D., a Professional Optometric Corporation PastSince Dec 1, 2024 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tdelengocky@retinadrs.intellechartdirect.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.

Hospital & facility affiliations 1

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1164637153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 3RD AVE",
            "address_2": "SUITE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111352",
            "telephone_number": "619-425-7755",
            "fax_number": "619-425-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 3RD AVE",
            "address_2": "SUITE A",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111352",
            "telephone_number": "619-425-7755",
            "fax_number": "619-425-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELENGOCKY",
        "first_name": "TAYSON",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036122962",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "20A12784",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "CA",
            "license": "20A12784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

Verify at the official NPI Registry.