Active NPI
Jonathan Tepper, M.D., PH.D.
- Psychiatry Physician
- Watsonville, CA
National Provider Identifier
1649482019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G52668
- Practice address
- 240 Westgate Dr Ste 122
Watsonville, CA 95076-2453 - Phone
- (831) 728-3939
- NPI assigned
- May 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G52668 | CA | Primary |
Addresses
Primary practice location
240 Westgate Dr Ste 122
Watsonville, CA 95076-2453
Mailing address
436 Snyder Ave
Aromas, CA 95004-9516
Phone (831) 726-9258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 30, 2016 through Jun 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G52668 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649482019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "436 SNYDER AVE",
"city": "AROMAS",
"state": "CA",
"postal_code": "950049516",
"telephone_number": "831-726-9258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 WESTGATE DR STE 122",
"city": "WATSONVILLE",
"state": "CA",
"postal_code": "950762453",
"telephone_number": "831-728-3939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEPPER",
"first_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G52668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watsonville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.