Active NPI
Lalita Khaodhiar Tantisira, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- C170095
- Practice address
- 12395 El Camino Real
San Diego, CA 92130-3082 - Phone
- (858) 793-2727
- NPI assigned
- Aug 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | C170095 | CA | Primary |
Addresses
Primary practice location
12395 El Camino Real
San Diego, CA 92130-3082
Mailing address
10790 Rancho Bernardo Rd
San Diego, CA 92127-5705
Phone (858) 793-2727
Other practice location 1
200 W Arbor Dr
San Diego, CA 92103-9000
Phone (800) 926-8273
Other names 1
- Lalita Khaodhiar
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12395 El Camino Real
Suite 112
San Diego, CA 92130-3084
Phone (858) 554-9100
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.77 of 100
- Quality
- 84.13
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.88
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.21 of 100
- Quality
- 90.43
- Promoting interoperability
- 90
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C170095 | CA | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scripps Health | Current | Accepting new patients | |
| Regents of the University of California | Endocrinology, Diabetes & Metabolism | Current | Accepting new patients |
| Scripps Health | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Regents of the University of California | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Regents of the University of California | Current | Accepting new patients | |
| Scripps Clinic Medical Group | Past | Accepting new patients |
Locations
9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123
File 54433
Los Angeles, CA 90074
Phone (858) 784-5645
12395 El Camino Real
Ste 317
San Diego, CA 92130
Phone (619) 793-0055
12395 El Camino Real
Ste 120
San Diego, CA 92130
Phone (858) 793-2727
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
12395 El Camino Real
San Diego, CA 92130
Phone (858) 793-2727
12395 El Camino Real
Ste 112
San Diego, CA 92130
Phone (619) 670-5400
10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626
Organizations & group practices 8
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.
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- Multi-Specialty Clinic/Center
- La Jolla, CA
- NPI 1275899072
-
- Pain Medicine (Anesthesiology) Physician
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- NPI 1376646869
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1508968751
Endocrinology, Diabetes & Metabolism
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
-
- Home Health Agency
- San Diego, CA
- NPI 1578556114
-
- General Acute Care Hospital
- La Jolla, CA
- NPI 1841277704
-
- Family Medicine Physician
- San Diego, CA
- NPI 1881636108
-
- Multi-Specialty Clinic/Center
- San Diego, CA
- NPI 1124003280
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731283200000",
"number": "1508874298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10790 RANCHO BERNARDO RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921275705",
"telephone_number": "858-793-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12395 EL CAMINO REAL",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303082",
"telephone_number": "858-793-2727"
}
],
"practiceLocations": [
{
"address_1": "200 W Arbor Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921039000",
"country_code": "US",
"telephone_number": "800-926-8273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TANTISIRA",
"first_name": "LALITA",
"middle_name": "KHAODHIAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "CA",
"license": "C170095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LALITA",
"last_name": "KHAODHIAR",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.