Wilfredo Manabat Tupas, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A49615 Issued in CA

Practice address

1700 N Waterman Ave
San Bernardino, CA 92404-5105

Phone

(909) 883-8611

Fax

(909) 886-1798

NPI assigned

Jan 25, 2006

Last updated

Mar 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Redlands Family Practice Medical Group Inc.

  dba Optum

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1942482021
  Medicare reassignment NPD
• Redlands Family Physicians Medical Associates, Inc.

  • Family Medicine Physician
  • Redlands, CA
  • NPI 1053390997
  NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1578533253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045105",
            "telephone_number": "909-883-8611",
            "fax_number": "909-886-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N WATERMAN AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045105",
            "telephone_number": "909-883-8611",
            "fax_number": "909-886-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPAS",
        "first_name": "WILFREDO",
        "middle_name": "MANABAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A49615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A496150",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tu Hoang MD a Professional Medical Corporation (Tu Hoang MD)
• Elijah Tuazon
• Leilanie Tubbs
• William Rodriguez Tucker
• Jasmine R Tunon
• Amanda Melissa Turcotte
• Emma Turk
• Dana Turkmany
• Irina Turlea, FNP-BC
• Austen Pierce Turner, DPT

• Internal Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.