Individual provider Active NPI

Jeffrey Tanji, MD

  • Sports Medicine (Family Medicine) Physician
  • Davis, CA
National Provider Identifier
1376529396
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
G51304 Issued in CA
Practice address
2440 W Covell Blvd
Davis, CA 95616-5671
Phone
(530) 747-3000
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X G51304 CA Primary

Addresses

Primary practice location

2440 W Covell Blvd
Davis, CA 95616-5671

Mailing address

2440 W Covell Blvd
Davis, CA 95616-5671
Phone (530) 747-3000

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
I20081217000185 CA Practitioner - Sports MedicinePractitioner - Family Practice 9739241209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G51304CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Ca CurrentSince Aug 22, 2018 Accepting new patients
Regents of the University of California CurrentSince May 20, 2008 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 22, 2018 Accepting new patients
Regents of the University of California CurrentSince May 20, 2008 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

643 W East Ave
Chico, CA 95926
Phone (530) 342-0502

2440 W Covell Blvd
Davis, CA 95616
Phone (530) 668-2646

2660 W Covell Blvd
Fl 2
Davis, CA 95616
Phone (530) 747-3000

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

3850 G St
Merced, CA 95340
Phone (209) 384-6528

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

10850 White Rock Rd
Rancho Cordova, CA 95670

2805 J St
Ste 300
Sacramento, CA 95816
Phone (916) 734-6805

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

Organizations & group practices 6

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1376529396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 W COVELL BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165671",
            "telephone_number": "530-747-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 W COVELL BLVD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956165671",
            "telephone_number": "530-747-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANJI",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "G51304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.