Active NPI
Robert M Tanaka, M.D.
- Pulmonary Disease Physician
- Modesto, CA
National Provider Identifier
1194764720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- G35094
- Practice address
- 600 Coffee Rd
Modesto, CA 95355-4201 - Phone
- (209) 524-1211
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G35094 | CA | |
| Pulmonary Disease Physician | 207RP1001X | G35094 | CA | Primary |
Addresses
Primary practice location
600 Coffee Rd
Modesto, CA 95355-4201
Mailing address
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G350940 | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- University of California, Geffen School of Medicine, 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500
2505 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050
2545 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050
2800 L St
Sacramento, CA 95816-5616
600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211
815 Court St
Jackson, CA 95642-2154
Hospital & facility affiliations
- Memorial Medical Center
- Adventist Health Sonora
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G35094 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Valley Hospitals | Past | Accepting new patients | |
| Sutter North Medical Foundation | Past | Accepting new patients |
Interoperability endpoints
- rtanaka9828@hisp.ehr.sutterhealth.org
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Modesto, CA
- NPI 1669846986
-
- Ambulatory Surgical Clinic/Center
- Yuba City, CA
- NPI 1144251521
-
- General Acute Care Hospital
- Modesto, CA
- NPI 1699129601
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Sonora, CA
- NPI 1780673376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297296000000",
"number": "1194764720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-524-1211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 COFFEE RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554201",
"telephone_number": "209-524-1211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANAKA",
"first_name": "ROBERT",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2011-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G35094",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CA",
"license": "G35094",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G350940",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.