Tracy Zivin-Tutela MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

TRACY ZIVIN-TUTELA MD

Practice address

11037 Warner Ave Ste 265
Fountain Valley, CA 92708-4007

Phone

(732) 672-1486

Fax

(470) 313-6152

NPI assigned

Apr 10, 2019

Organization subpart

No

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

Authorized official

Name

Tracy Zivin-Tutela, MDNPI 1841230646

Title

President

Phone

(732) 672-1486

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Tracy Hope Zivin-Tutela, MD

  • Infectious Disease Physician
  • Fountain Valley, CA
  • NPI 1841230646
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1609339258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE STE 265",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "732-672-1486",
            "fax_number": "470-313-6152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE STE 265",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "732-672-1486",
            "fax_number": "470-313-6152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY ZIVIN-TUTELA MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2021-12-06",
        "certification_date": "2021-11-29",
        "status": "A",
        "authorized_official_last_name": "ZIVIN-TUTELA",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-672-1486",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.