Individual provider Active NPI

Tristan Teague Seton

  • Student in an Organized Health Care Education/Training Program
  • Wilkes Barre, PA
National Provider Identifier
1609455716
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A209015 Issued in CA
Practice address
205 E River Park Cir Ste 460
Fresno, CA 93720-1585
Phone
(559) 261-4500
NPI assigned
Apr 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A209015 CA Primary

Addresses

Primary practice location

205 E River Park Cir Ste 460
Fresno, CA 93720-1585

Mailing address

205 E River Park Cir Ste 460
Fresno, CA 93720-1585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210706000620 PA Order and Referring Only - General SurgeryPractitioner - General Surgery 5395147904

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Drexel University College of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

45 E River Park PL W
Suite 507
Fresno, CA 93720-1565

PO Box
Los Angeles, CA 90088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1609455716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E RIVER PARK CIR STE 460",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E RIVER PARK CIR STE 460",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937201585",
            "telephone_number": "559-261-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETON",
        "first_name": "TRISTAN",
        "middle_name": "TEAGUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A209015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.