Individual provider Active NPI

Richard Taketa, M.D.

  • Diagnostic Radiology Physician
  • Irvine, CA
National Provider Identifier
1639113269
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A23741 Issued in CA
Practice address
16100 Sand Canyon Ave
Suite 100
Irvine, CA 92618-3716
Phone
(949) 417-1100
Fax
(949) 417-1165
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X A23741 CA
Diagnostic Radiology Physician 2085R0202X A23741 CA Primary

Addresses

Primary practice location

16100 Sand Canyon Ave
Suite 100
Irvine, CA 92618-3716

Mailing address

Dept la 21555
Pasadena, CA 91185-1555
Phone (949) 764-5570

Other identifiers 2

IdentifierTypeStateIssuer
00A237410OtherCABLUE SHIELD
00A237410MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Harbor Radiology Associates Medical Group, Inc Nuclear Medicine Current Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Newport Center Radiology Associates Medical Group Inc Nuclear Medicine Past Accepting new patients

Locations

16200 Sand Canyon Ave
Irvine, CA 92618
Phone (949) 753-2000

18301 Von Karman Ave
Ste 310
Irvine, CA 92612
Phone (949) 645-3534

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

Dept LA 21555
Pasadena, CA 91185
Phone (949) 236-8620

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1639113269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21555",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851555",
            "telephone_number": "949-764-5570",
            "fax_number": "949-263-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 SAND CANYON AVE",
            "address_2": "SUITE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183716",
            "telephone_number": "949-417-1100",
            "fax_number": "949-417-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKETA",
        "first_name": "RICHARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "CA",
            "license": "A23741",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A23741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00A237410",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A237410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.