Individual provider Active NPI

Arielle Tucker, MD

  • Family Medicine Physician
  • Gardena, CA
National Provider Identifier
1376005637
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A182828 Issued in CA
Practice address
1212 W Redondo Beach Blvd
Gardena, CA 90247-3411
Phone
(310) 324-2592
NPI assigned
Apr 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A182828 CA Primary

Addresses

Primary practice location

1212 W Redondo Beach Blvd
Gardena, CA 90247-3411

Mailing address

4455 W 117TH St Ste 200
Hawthorne, CA 90250-2240
Phone (310) 219-2000

Other practice location 1

4455 W 117th St Ste 200
Hawthorne, CA 90250-2240
Phone (310) 219-2000

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
I20221111000360 CA Practitioner - Family Practice 3476920067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Community ClinicGroup PAC ID 5193710275, 21 clinicians

Practice addresses (Care Compare)

4455 W 117TH St
Hawthorne, CA 90250-2240

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A182828CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Oct 10, 2022 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 10, 2022 Accepting new patients
Northeast Community Clinic Family Medicine Current Accepting new patients

Locations

2550 W Main St
Ste 301
Alhambra, CA 91801
Phone (626) 457-6900

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1212 W Redondo Beach Blvd
Gardena, CA 90247
Phone (310) 225-2825

4455 W 117th St
Ste 200
Hawthorne, CA 90250
Phone (310) 219-2000

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

200 E Anaheim St
Wilmington, CA 90744
Phone (310) 522-8700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1376005637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 W 117TH ST STE 200",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502240",
            "telephone_number": "310-219-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 W REDONDO BEACH BLVD",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473411",
            "telephone_number": "310-324-2592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4455 W 117th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "CA",
            "postal_code": "902502240",
            "country_code": "US",
            "telephone_number": "310-219-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ARIELLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A182828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

Verify at the official NPI Registry.