NPIMap

Individual provider Active NPI

Teferi Yilma Mitiku, M.D.

  • Cardiovascular Disease Physician
  • Orange, CA
National Provider Identifier
1316096522
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301101657 Issued in MI
Practice address
101 City Drive South
Orange, CA 92868
Phone
(714) 456-3868
Fax
(313) 745-4399
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A92724 CA
Internal Medicine Physician 207R00000X 4301101657 MI
Cardiovascular Disease Physician 207RC0000X 4301101657 MI Primary

Addresses

Primary practice location

101 City Drive South
Orange, CA 92868

Mailing address

333 Corporate Dr
Ste 102
Ladera Ranch, CA 92694-2113
Phone (714) 456-3868

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
I20140812000833 CA Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Cardiac Electrophysiology 6709988918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)
Education
University of California, Geffen School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ccoc, Inc.Group PAC ID 0840332474, 4 clinicians

Practice addresses (Care Compare)

333 Corporate Dr
Suite 102
Ladera Ranch, CA 92694-2113
Phone (949) 276-2446

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
96.78
Improvement activities
40
Cost
64.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair23

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents CurrentSince Aug 15, 2014 Accepting new patients
Ccoc, Inc. CurrentSince Jan 17, 2022 Accepting new patients
UC Regents Current Accepting new patients
UC Regents Cardiovascular Disease CurrentSince Aug 15, 2014 Accepting new patients
Sinai Hospital of Greater Detroit Past Accepting new patients
Sinai Hospital of Greater Detroit Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
University Physician Group Internal Medicine Past Accepting new patients
VHS Detroit Receiving Hospital Inc Past Accepting new patients
Wayne State University School of Medicine Past Accepting new patients
VHS Huron Valley-Sinai Hospital Inc Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

16305 Sand Canyon Ave
Ste 255
Irvine, CA 92618
Phone (949) 443-4303

16200 Sand Canyon Ave
Irvine, CA 92618
Phone (949) 753-2000

333 Corporate Dr
Ste 102
Mission Viejo, CA 92694
Phone (949) 276-2446

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

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: tmitiku182043@direct.llu.edu

Organizations & group practices 12

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 3

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1316096522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CORPORATE DR",
            "address_2": "STE 102",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926942113",
            "telephone_number": "714-456-3868",
            "fax_number": "313-745-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CITY DRIVE SOUTH",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "92868",
            "telephone_number": "714-456-3868",
            "fax_number": "313-745-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITIKU",
        "first_name": "TEFERI",
        "middle_name": "YILMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A92724",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301101657",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301101657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.