Raelynn M Tucker, M.D.

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

A77146 Issued in CA

Practice address

31872 Coast Hwy
Laguna Beach, CA 92651-6773

Phone

(949) 499-7288

Fax

(949) 499-7248

NPI assigned

Jun 5, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

PathologyAlso: Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newport Harbor Pathology Medical Group IncGroup PAC ID 1456312396, 27 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.5 of 100Reported as group

Quality

70

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Newport Harbor Pathology Medical Group Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Newport Beach, CA
  • NPI 1790711927
  Medicare reassignment Care Compare group NPD
• Newport Harbor Pathology Medical Group Inc

  • Clinical Medical Laboratory
  • Orange, CA
  • NPI 1619423282
  NPD

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1356577258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31872 COAST HWY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926516773",
            "telephone_number": "949-499-7288",
            "fax_number": "949-499-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31872 COAST HWY",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926516773",
            "telephone_number": "949-499-7288",
            "fax_number": "949-499-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "RAELYNN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "A77146",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A77146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatopathology (Pathology) Physician in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• Dermatopathology (Pathology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.