Individual provider Active NPI

Kevin D. Tubbs, D.O.

  • Emergency Medicine Physician
  • Huntington Beach, CA
National Provider Identifier
1477504553
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A6172 Issued in CA
Practice address
17772 Beach Blvd
Huntington Beach, CA 92647
Phone
(714) 842-1473
NPI assigned
May 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A6172 CA Primary

Addresses

Primary practice location

17772 Beach Blvd
Huntington Beach, CA 92647

Mailing address

PO Box 660519
Arcadia, CA 91066-0519
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
00AX61720MedicaidCA

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
I20041208000523 CA Practitioner - Emergency Medicine 5799741062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.69 of 100Reported as group
Quality
90
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A6172CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
Beach Emergency Medical Associates Emergency Medicine PastSince Nov 15, 2020 Accepting new patients
Garfield Emergency Medical Associates, Inc. Emergency Medicine Past Accepting new patients
Huntington Beach Medical Group Past Accepting new patients

Locations

751 Medical Center Ct
#1182
Chula Vista, CA 91911

9920 Talbert Ave
Fountain Vly, CA 92708
Phone (714) 236-4000

24451 Health Center Dr
Laguna Hills, CA 92653
Phone (949) 452-3573

22855 Lake Forest Dr
Ste A
Lake Forest, CA 92630
Phone (949) 452-7544

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

654 Camino de los Mares
San Clemente, CA 92673
Phone (949) 489-4507

Interoperability endpoints

  • Direct secure messaging: ktubbs69859@direct.memorialcare.org

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

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1477504553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660519",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910660519",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17772 BEACH BLVD",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "92647",
            "telephone_number": "714-842-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUBBS",
        "first_name": "KEVIN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A6172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX61720",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

Verify at the official NPI Registry.