Tetsuya Takeuchi, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036133452 Issued in IL

Practice address

5668 E State St
Rockford, IL 61108-2464

Phone

(815) 229-7580

NPI assigned

Nov 2, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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

General Surgery

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oc Trauma IncGroup PAC ID 7214205152, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
• Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oc Trauma Inc

  • Trauma Surgery Physician
  • Mission Viejo, CA
  • NPI 1720516628
  Medicare reassignment Care Compare group
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549
  Medicare reassignment NPD
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Westminster, CO
  • NPI 1477239267
  NPD (past)
• Sutter North Medical Foundation

  dba Sutter North Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Yuba City, CA
  • NPI 1144251521
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  dba Providence Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1912108002
  Care Compare affiliation
• Mission Hospital Regional Medical Center

  dba Mission Hospital

  • General Acute Care Hospital
  • Mission Viejo, CA
  • NPI 1992752315
  Care Compare affiliation

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1447550884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-229-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5668 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082464",
            "telephone_number": "815-229-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEUCHI",
        "first_name": "TETSUYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-02",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036133452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigh Ann Tackaberry, M.A., F-AAA
• Steven Ronald Taddei, AU.D.
• Luis Tafolla
• Dominic Tagler
• Hena Tahir, OD, MS
• Mitchell Glenn Eustaquio Tan, DNP, APRN,PMHNP-BC
• Brenda Marie Tanker
• Ty Alexander Tanker, AU.D.
• Eric Jon Tanner, LCPC
• George Chahine Tannous, M.D.

• Surgery Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.