Individual provider Active NPI

Charles Berry Tesar, M.D.

  • Otolaryngology Physician
  • San Diego, CA
National Provider Identifier
1497866016
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G46482 Issued in CA
Practice address
2929 Health Center Dr
San Diego, CA 92123-2762
Phone
(858) 939-6621
Fax
(858) 874-2348
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G46482 CA Primary

Addresses

Primary practice location

2929 Health Center Dr
San Diego, CA 92123-2762

Mailing address

2929 Health Center Dr
San Diego, CA 92123-2762
Phone (858) 939-6621

Other identifiers 1

IdentifierTypeStateIssuer
00G464820MedicaidCA

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
I20080603000847 CA Practitioner - Otolaryngology 0446320394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G46482CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jul 11, 1988 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc Otolaryngology CurrentSince Jul 11, 1988 Accepting new patients
Emergency and Acute Care Medical Corporation PastSince Jan 14, 2024 Accepting new patients

Locations

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

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

2929 Health Center Dr
San Diego, CA 92123
Phone (858) 939-6531

5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340

Interoperability endpoints

  • Direct secure messaging: ctesar32475@sharphealthcare.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1497866016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 HEALTH CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232762",
            "telephone_number": "858-939-6621",
            "fax_number": "858-874-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 HEALTH CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232762",
            "telephone_number": "858-939-6621",
            "fax_number": "858-874-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESAR",
        "first_name": "CHARLES",
        "middle_name": "BERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G46482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G464820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.