NPIMap

Individual provider Active NPI

Teresa Tabora Soriano, MD

  • Dermatology Physician
  • Los Angeles, CA
National Provider Identifier
1629158217
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A62639 Issued in CA
Practice address
200 Medical Plaza
#450
Los Angeles, CA 90095
Phone
(310) 825-6911
Fax
(310) 794-7005
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A62639 CA Primary

Addresses

Primary practice location

200 Medical Plaza
#450
Los Angeles, CA 90095

Mailing address

200 Medical Plaza
465
Los Angeles, CA 90095
Phone (310) 825-6911

Other identifiers 1

IdentifierTypeStateIssuer
00G629740MedicaidCA

Other names 1

  • Maria Tabora Soriano Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121108000032 CA Practitioner - Dermatology 2466603089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of California, Davis School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 8426956160, 33 clinicians

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001

100 Medical PLZ
Suite 310
Los Angeles, CA 90095-0001
Phone (310) 825-7922

200 Medical Plaza
Los Angeles, CA 90095-0001

200 Medical PLZ
Los Angeles, CA 90095-0001

200 UCLA Medical PLZ
Suite 165 34
Los Angeles, CA 90095-0001
Phone (310) 824-8403

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

2020 Santa Monica Blvd
Suite 510
Santa Monica, CA 90404-2131
Phone (310) 582-6360

900 Weyburn Place
Suite 14 171
Los Angeles, CA 90095-0001
Phone (310) 825-8173

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
89.72
Promoting interoperability
100
Improvement activities
40
Cost
67.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision81
Removal of skin lesions1509
Removal of skin cancer1093
Removal or shaving of skin growth1-10
Skin biopsy812

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Dermatology CurrentSince Sep 17, 2012 Accepting new patients
The Regents of the University of California CurrentSince Aug 4, 2013 Accepting new patients
The Regents of the University of California CurrentSince Aug 4, 2013 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Medical Group Dermatology Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

File 55737
Los Angeles, CA 90074

200 UCLA Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

100 UCLA Medical Plz
Ste 216
Los Angeles, CA 90024
Phone (310) 208-2266

200 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-6688

200 Medical Plz
Ste 465
Los Angeles, CA 90095
Phone (310) 825-5510

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

Interoperability endpoints

  • Direct secure messaging: tsoriano48278@direct.uclahealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1629158217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "465",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-825-6911",
            "fax_number": "310-794-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PLAZA",
            "address_2": "#450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-825-6911",
            "fax_number": "310-794-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIANO",
        "first_name": "TERESA",
        "middle_name": "TABORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A62639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G629740",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "SORIANO",
            "middle_name": "TABORA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.