NPIMap

Organization Active NPI

DHP of Twin Cities Medical Group Inc

  • Orthopaedic Surgery Physician
  • Templeton, CA
National Provider Identifier
1295082857
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
DHP OF TWIN CITIES MEDICAL GROUP INC
Practice address
1100 Las Tablas Rd
Templeton, CA 93465-9704
Phone
(805) 434-3500
NPI assigned
Aug 13, 2012
Last updated
Aug 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Authorized official

Name
Dr. Sujal Mandavia, M.D.
Title
President
Phone
(865) 693-1000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X

Addresses

Primary practice location

1100 Las Tablas Rd
Templeton, CA 93465-9704

Mailing address

265 Brookview Centre Way
Suite 400
Knoxville, TN 37919-4052
Phone (865) 693-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120927000352 CA Part B Supplier - Clinic/Group Practice 0840449385 Receives reassigned benefits from 10 practitioners
Practice locations: Templeton, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344816000000",
    "number": "1295082857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BROOKVIEW CENTRE WAY",
            "address_2": "SUITE 400",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194052",
            "telephone_number": "865-693-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAS TABLAS RD",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659704",
            "telephone_number": "805-434-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHP OF TWIN CITIES MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-13",
        "last_updated": "2012-08-13",
        "status": "A",
        "authorized_official_last_name": "MANDAVIA",
        "authorized_official_first_name": "SUJAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-693-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.