NPIMap

Individual provider Active NPI

Ted Yoshio Fisher, M.D.

  • Vascular Surgery Physician
  • Brawley, CA
National Provider Identifier
1538178355
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
A052523 Issued in CA
Practice address
628 G St
Brawley, CA 92227-2544
Phone
(760) 344-1101
NPI assigned
Aug 8, 2006
Last updated
May 9, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X K0033 TX
Vascular Surgery Physician 2086S0129X A052523 CA Primary

Addresses

Primary practice location

628 G St
Brawley, CA 92227-2544

Mailing address

628 G St
Brawley, CA 92227-2544
Phone (972) 822-1957

Other identifiers 1

IdentifierTypeStateIssuer
680560958OtherTXTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: General Surgery
Education
Uniformed Services Uhs Fe Hebert School of Med, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3746 Foothill Blvd
B140
Glendale, CA 91214-1740

4404 Placidia Ave
Toluca Lake, CA 91602-2419

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A052523CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Ted Y Fisher a Professional Corporation Current Accepting new patients
Taylor Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Fossil Rim Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Palm Valley Emergency Physicians Specialists PLLC Past Accepting new patients
Questcare Medical Services PLLC Emergency Medicine Past Accepting new patients
East Texas Medical Center Healthcare Associates Emergency Medicine Past Accepting new patients
Panola Emergency Medicine Associates PA Emergency Medicine Past Accepting new patients
Texas Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Sheridan Healthcare of Texas PA Past Accepting new patients
Memorial Hospital of Polk County PastSince Jan 1, 2002 Accepting new patients
Western Trail Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
Harlingen Emergency Medical Associates, PA Emergency Medicine Past Accepting new patients
Gainesville Hospital District Past Accepting new patients
Texas Diagnostic Imaging, P.a. Past Accepting new patients

Locations

628 G St
Brawley, CA 92227
Phone (760) 344-1101

Interoperability endpoints

  • Direct secure messaging: dmctfishe@yourcarecommunity.org

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1538178355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 G ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272544",
            "telephone_number": "972-822-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 G ST",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922272544",
            "telephone_number": "760-344-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "TED",
        "middle_name": "YOSHIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K0033",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A052523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "680560958",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

Verify at the official NPI Registry.