Individual provider Active NPI

Michael Tedla, MD

  • Cardiovascular Disease Physician
  • Bradenton, FL
National Provider Identifier
1689061657
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME149544 Issued in FL
Practice address
2210 61St St W
Bradenton, FL 34209-5527
Phone
(941) 747-8789
NPI assigned
Apr 17, 2015
Last updated
Nov 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X LL2769 NV
Cardiovascular Disease Physician 207RC0000X ME149544 FL Primary

Addresses

Primary practice location

2210 61St St W
Bradenton, FL 34209-5527

Mailing address

2210 61St St W
Bradenton, FL 34209-5527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20220614000430 FL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3274849708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Solutions Institute LLCGroup PAC ID 1759552870, 2 clinicians

Practice addresses (Care Compare)

2210 61St St W
Bradenton, FL 34209-5527
Phone (941) 747-8789

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.12 of 100Reported as individual
Quality
79.7
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting62
Pacemaker insertion or repair23
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL2769NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Solutions Institute Outpatient Services, LLC Cardiovascular Disease CurrentSince Aug 1, 2023 Accepting new patients
Cardiovascular Solutions Institute LLC Cardiovascular Disease CurrentSince Jul 1, 2022 Accepting new patients

Locations

2210 61st St W
Bradenton, FL 34209
Phone (941) 747-8789

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3447/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.tedla.1@3447.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1689061657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 61ST ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095527",
            "telephone_number": "941-747-8789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDLA",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "LL2769",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME149544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.