Individual provider Active NPI

Christopher Makoto Tsueda, M.D.

  • Family Medicine Physician
  • Wright Patterson AFB, OH
National Provider Identifier
1255395174
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20031303 Issued in NC
Practice address
88 MDG/SGHJ
4881 Sugar Maple Dr.
Wright-Patterson AFB, OH 45433
Phone
(937) 268-6511
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20031303 NC Primary

Addresses

Primary practice location

88 MDG/SGHJ
4881 Sugar Maple Dr.
Wright-Patterson AFB, OH 45433

Mailing address

88 MDG/SGHJ
4881 Sugar Maple Dr.
Wright-Patterson Af, OH 45433
Phone (937) 268-6511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20141009002085 OH Order and Referring Only - Family PracticePractitioner - Family Practice 4587884713

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20031303NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Summit Medical Center Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1255395174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 MDG/SGHJ",
            "address_2": "4881 SUGAR MAPLE DR.",
            "city": "WRIGHT-PATTERSON AF",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-268-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 MDG/SGHJ",
            "address_2": "4881 SUGAR MAPLE DR.",
            "city": "WRIGHT-PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-268-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUEDA",
        "first_name": "CHRISTOPHER",
        "middle_name": "MAKOTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "20031303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wright Patterson AFB, OH

Sources for this page

Verify at the official NPI Registry.