Individual provider Active NPI

Tshekedi Galen Dennis, MD

  • Psychiatry Physician
  • Huntington Beach, CA
National Provider Identifier
1215015508
Registry record updated Dec 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A96369 Issued in CA
Practice address
5762 Bolsa Ave
Suite 107
Huntington Beach, CA 92649-1172
Phone
(714) 898-0362
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A96369 CA Primary

Addresses

Primary practice location

5762 Bolsa Ave
Suite 107
Huntington Beach, CA 92649-1172

Mailing address

5762 Bolsa Ave Ste 107
Huntington Beach, CA 92649-1172
Phone (714) 898-0362

Other practice location 1

12511 Brookhurst St
Garden Grove, CA 92840-4806
Phone (714) 643-7176

Other practice location 2

265 S Anita Dr Ste 102-104
Orange, CA 92868-3355
Phone (714) 410-3500

Other practice location 3

999 N Tustin Ave Ste 216
Santa Ana, CA 92705-6506
Phone (714) 545-5550

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
I20090216000052 CA Practitioner - PsychiatryPractitioner - Neurology 9830254432 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Neuropsychiatric Specialists IncGroup PAC ID 3375796170, 70 clinicians

Practice addresses (Care Compare)

19671 Beach Blvd
Suite 215
Huntington Beach, CA 92648-5903
Phone (714) 545-5550

3151 Airway Ave
Suite G1
Costa Mesa, CA 92626-4624
Phone (714) 545-5550

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96369CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Oct 10, 2019 Accepting new patients
Mission City Community Network, Inc. CurrentSince Oct 10, 2019 Accepting new patients
Associated Therapists, Inc. Psychiatry CurrentSince May 25, 2021 Accepting new patients
Mission City Community Network, Inc. Current Accepting new patients
County of Riverside CurrentSince Aug 31, 2015 Accepting new patients
County of Riverside Current Accepting new patients
Central City Community Health Center Inc CurrentSince May 24, 2023 Accepting new patients
Central City Community Health Center Inc CurrentSince May 24, 2023 Accepting new patients
County of Riverside CurrentSince Aug 31, 2015 Accepting new patients
Autism 360 Support LLC CurrentSince Jul 24, 2022 Accepting new patients
Renew Behavorial Health Inc CurrentSince Feb 17, 2024 Accepting new patients
Pacific Health Systems, L.P. Psychiatry PastSince Oct 1, 2005 Accepting new patients
Advanced TMS Clinic Inc Psychiatry PastSince May 24, 2020 Accepting new patients
Hoag Hospital Past Accepting new patients
Market Pharmacy LLC PastSince Sep 5, 2023 Accepting new patients
Exodus Recovery, Inc. PastSince Nov 22, 2020 Accepting new patients
Hurtt Family Health Clinic Inc PastSince Dec 1, 2019 Accepting new patients

Locations

2243 W Ball Rd
Anaheim, CA 92804
Phone (714) 490-2750

4160 Maine Ave
Baldwin Park, CA 91706
Phone (323) 724-0019

12511 Brookhurst St
Garden Grove, CA 92840
Phone (714) 534-5050

5762 Bolsa Ave
Ste 107
Huntington Beach, CA 92649
Phone (714) 891-7301

4000 Long Beach Blvd
Ste 228
Long Beach, CA 90807
Phone (310) 422-4426

4000 Long Beach Blvd
Ste 2
Long Beach, CA 90807
Phone (562) 637-3143

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

9990 County Farm Rd
Ste 2
Riverside, CA 92503
Phone (951) 358-4790

15206 Parthenia St
Sepulveda, CA 91343

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADEBAA
  • Direct secure messaging: tdennis100901@direct.llu.edu
  • Direct secure messaging: drdennis@pnsi-ca.direct.office.nextgen.com

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735430400000",
    "number": "1215015508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5762 BOLSA AVE STE 107",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491172",
            "telephone_number": "714-898-0362",
            "fax_number": "714-893-3267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5762 BOLSA AVE",
            "address_2": "SUITE 107",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926491172",
            "telephone_number": "714-898-0362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12511 Brookhurst St",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928404806",
            "country_code": "US",
            "telephone_number": "714-643-7176",
            "fax_number": "714-881-2855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "265 S Anita Dr Ste 102-104",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683355",
            "country_code": "US",
            "telephone_number": "714-410-3500",
            "fax_number": "714-410-3527",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N Tustin Ave Ste 216",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927056506",
            "country_code": "US",
            "telephone_number": "714-545-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "TSHEKEDI",
        "middle_name": "GALEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A96369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.