NPIMap

Organization Active NPI

Ted Medical Group, Inc.

  • Internal Medicine Physician
  • Garden Grove, CA
National Provider Identifier
1497396451
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TED MEDICAL GROUP, INC.
Practice address
12865 Main St Ste 105
Garden Grove, CA 92840-8205
Phone
(800) 560-9999
NPI assigned
Oct 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Authorized official

Name
Emily NguyenNPI 1033057872
Title
Administrator
Phone
(800) 560-9999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12865 Main St Ste 105
Garden Grove, CA 92840-8205

Mailing address

12865 Main St Ste 105
Garden Grove, CA 92840-8205
Phone (800) 560-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191226001520 CA Part B Supplier - Clinic/Group Practice 3870927908 Receives reassigned benefits from 5 practitioners
Practice locations: Garden Grove, CA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569888000000",
    "number": "1497396451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12865 MAIN ST STE 105",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928408205",
            "telephone_number": "800-560-9999",
            "fax_number": "800-391-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12865 MAIN ST STE 105",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928408205",
            "telephone_number": "800-560-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-10-01",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "800-560-9999"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.