Individual provider Active NPI

Tapas Kaneyalal Tejura, M.D.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1326253279
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A110917 Issued in CA
Practice address
1500 San Pablo St FL 2
Los Angeles, CA 90033
Phone
(323) 442-8541
Fax
(323) 442-8755
NPI assigned
May 14, 2007
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A110917 CA Primary

Addresses

Primary practice location

1500 San Pablo St FL 2
Los Angeles, CA 90033

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-8541

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL tapas.tejura@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20100803001001 CA Practitioner - Diagnostic Radiology 8224161831 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A110917CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2011 Accepting new patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Jun 1, 2011 Accepting new patients
Usc Radiology Associates Past Accepting new patients

Locations

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1326253279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-442-8541",
            "fax_number": "323-442-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJURA",
        "first_name": "TAPAS",
        "middle_name": "KANEYALAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A110917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "tapas.tejura@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 San Pablo St Fl 2",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "90033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.