Individual provider Active NPI

Garo M. Tertzakian

  • Urology Physician
  • Santa Ana, CA
National Provider Identifier
1699786400
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
C37346 Issued in CA
Practice address
801 N Tustin Ave Ste 202
Santa Ana, CA 92705-3600
Phone
(714) 480-0208
Fax
(714) 480-0210
NPI assigned
Aug 10, 2006
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X C37346 CA Primary

Addresses

Primary practice location

801 N Tustin Ave Ste 202
Santa Ana, CA 92705-3600

Mailing address

801 N Tustin Ave Ste 202
Santa Ana, CA 92705-3600
Phone (714) 480-0208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070426000313 CA Practitioner - Urology 1153427893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

801 N Tustin Ave
Suite 202
Santa Ana, CA 92705-3600
Phone (714) 480-0810

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C37346CAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital of Orange County Past Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 2

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1699786400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N TUSTIN AVE STE 202",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053600",
            "telephone_number": "714-480-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N TUSTIN AVE STE 202",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053600",
            "telephone_number": "714-480-0208",
            "fax_number": "714-480-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERTZAKIAN",
        "first_name": "GARO",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "C37346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.