NPIMap

Individual provider Active NPI

Rocco R. Tutela Jr., M.D.

  • Surgery Physician
  • Fountain Valley, CA
National Provider Identifier
1306979208
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C168048 Issued in CA
Practice address
11100 Warner Ave Ste 258
Fountain Valley, CA 92708-7512
Phone
(714) 868-6066
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA07918500 NJ
Surgery Physician 208600000X C168048 CA Primary

Addresses

Primary practice location

11100 Warner Ave Ste 258
Fountain Valley, CA 92708-7512

Mailing address

11037 Warner Ave
# 265
Fountain Valley, CA 92708-4007
Phone (732) 846-9500

Other practice location 1

17100 Euclid St
Fountain Valley, CA 92708-4043
Phone (714) 966-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210513002545 CA Practitioner - General Surgery 9032210190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11100 Warner Ave
Suite 258
Fountain Valley, CA 92708-7512
Phone (714) 868-6066

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Coronary artery bypass graft (CABG)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue136
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rocco Tutela Jr M D Inc Surgery CurrentSince Jan 1, 2021 Accepting new patients
Saint Peters University Hospital Past Accepting new patients
Robert Wood Johnson University Hospital, Inc Past Accepting new patients
Sovereign Medical Group LLC Surgery Past Accepting new patients
P. F. Ioffreda, MD, PA PastSince May 18, 1993 Accepting new patients

Locations

11037 Warner Ave
#265
Fountain Valley, CA 92708

11100 Warner Ave
Ste 258
Fountain Vly, CA 92708
Phone (714) 549-5990

17100 Euclid St
Fountain Vly, CA 92708
Phone (714) 966-7200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16558/brand/1/csg/1/fhir/r4

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 6

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1306979208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE",
            "address_2": "# 265",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "732-846-9500",
            "fax_number": "732-846-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 258",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087512",
            "telephone_number": "714-868-6066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17100 Euclid St",
            "address_purpose": "LOCATION",
            "city": "Fountain Valley",
            "state": "CA",
            "postal_code": "927084043",
            "country_code": "US",
            "telephone_number": "714-966-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUTELA",
        "first_name": "ROCCO",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07918500",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C168048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.