Individual provider Active NPI

Krishnansu Sujata Tewari, M.D.

  • Gynecologic Oncology Physician
  • Orange, CA
National Provider Identifier
1205868445
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
A601614 Issued in CA
Practice address
101 The City Dr S
Orange, CA 92868-3201
Phone
(714) 456-6431
Fax
(714) 456-7754
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X A601614 CA Primary

Addresses

Primary practice location

101 The City Dr S
Orange, CA 92868-3201

Mailing address

PO Box 513980
Los Angeles, CA 90051-3980
Phone (714) 456-6431

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
I20040728001213 CA Practitioner - Obstetrics/Gynecology 2365412285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Regents of the University of CaliforniaGroup PAC ID 0143128009, 51 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7002

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of the uterus14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A601614CAMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Gynecologic Oncology CurrentSince May 1, 2016 Accepting new patients
University of California Irvine Past Accepting new patients
University of California Irvine Past Accepting new patients
St. Joseph Hospital of Orange Past Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients

Locations

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

19208 Jamboree Rd
Irvine, CA 92612
Phone (657) 579-3460

23961 Calle de la Magdalena
Ste 4
Laguna Hills, CA 92653

701 E 28th St
Ste 213
Long Beach, CA 90806

2810 Long Beach Blvd
Long Beach, CA 90806
Phone (562) 933-1877

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

101 The City Dr S
Bldg 23
Orange, CA 92868
Phone (714) 456-5889

101 The City Dr S
Bldg 29
Orange, CA 92868
Phone (714) 456-7005

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

1000 W La Veta Ave
Orange, CA 92868
Phone (714) 446-5632

101 The City Dr S
Ste 501
Orange, CA 92868

Interoperability endpoints

  • Direct secure messaging: ktewari17512@direct.memorialcare.org

Organizations & group practices 5

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 4

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1205868445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513980",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900513980",
            "telephone_number": "714-456-6431",
            "fax_number": "714-456-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-6431",
            "fax_number": "714-456-7754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEWARI",
        "first_name": "KRISHNANSU",
        "middle_name": "SUJATA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "A601614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.