NPIMap

Individual provider Active NPI

Tessa Marcelle Buchan Antalan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • San Diego, CA
National Provider Identifier
1427346758
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A130238 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103-9000
Phone
(800) 926-8273
NPI assigned
Jul 20, 2011
Last updated
Apr 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A130238 CA
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A130238 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103-9000

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Other practice location 1

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other practice location 2

3544 30th St
San Diego, CA 92104-4120
Phone (619) 515-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150724011640 CA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 2668785205 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A130238CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc CurrentSince Aug 2, 2016 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 2, 2016 Accepting new patients
Regents of the University of California Current Accepting new patients
Emergency and Acute Care Medical Corporation CurrentSince Sep 30, 2019 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Regents of the University of California Internal Medicine CurrentSince Mar 19, 2021 Accepting new patients
Regents of the University of California CurrentSince Mar 19, 2021 Accepting new patients
Kolli Medical Corporation Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients
Scripps Health Past Accepting new patients
Grossmont Hospital Corporation Past Accepting new patients
Regents of the University of California Past Accepting new patients
El Centro Regional Medical Center Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

1600 E Florida Ave
Ste 103
Hemet, CA 92544
Phone (951) 925-6625

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

3544 30th St
San Diego, CA 92104
Phone (619) 515-2424

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1427346758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "800-926-8273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "823 GATEWAY CENTER WAY",
            "address_purpose": "LOCATION",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "country_code": "US",
            "telephone_number": "619-515-2300",
            "fax_number": "619-906-4564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3544 30th St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921044120",
            "country_code": "US",
            "telephone_number": "619-515-2424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTALAN",
        "first_name": "TESSA",
        "middle_name": "MARCELLE BUCHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A130238",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A130238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.