Individual provider Active NPI

Jonathan Tye, M.D.

  • Cardiovascular Disease Physician
  • West Covina, CA
National Provider Identifier
1417057068
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A44747 Issued in CA
Practice address
1250 S Sunset Ave
Ste 202
West Covina, CA 91790-3961
Phone
(626) 960-6588
Fax
(626) 338-0688
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A44747 CA Primary

Addresses

Primary practice location

1250 S Sunset Ave
Ste 202
West Covina, CA 91790-3961

Mailing address

1250 S Sunset Ave
Ste 202
West Covina, CA 91790-3961
Phone (626) 960-6588

Other identifiers 1

IdentifierTypeStateIssuer
00A44747MedicaidCA

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
I20120207000835 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8426215179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1250 S Sunset Ave
Suite 202
West Covina, CA 91790-3962

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting44
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A44747CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Center Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1417057068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 S SUNSET AVE",
            "address_2": "STE 202",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903961",
            "telephone_number": "626-960-6588",
            "fax_number": "626-338-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S SUNSET AVE",
            "address_2": "STE 202",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903961",
            "telephone_number": "626-960-6588",
            "fax_number": "626-338-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYE",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A44747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A44747",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.