Individual provider Active NPI

Mediget Teshome, MD

  • Surgical Oncology Physician
  • Los Angeles, CA
National Provider Identifier
1699963678
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
A101388 Issued in CA
Practice address
100 Medical Plaza Suite 310
Los Angeles, CA 90095-4009
Phone
(310) 825-2144
NPI assigned
Oct 4, 2007
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X P7360 TX
Surgical Oncology Physician 2086X0206X A101388 CA Primary

Addresses

Primary practice location

100 Medical Plaza Suite 310
Los Angeles, CA 90095-4009

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 1

IdentifierTypeStateIssuer
331808101MedicaidTX

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
I20231114002838 CA Practitioner - General SurgeryPractitioner - Other (Physician) 8820229289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Michigan Medical School, 2006
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 8921076795, 14 clinicians

Practice addresses (Care Compare)

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

1223 16TH St
Suite 1100
Santa Monica, CA 90404-1217
Phone (424) 259-8791

191 S Buena Vista St
Suite 415
Burbank, CA 91505-4541
Phone (818) 333-2555

200 Medical Plaza
Suite 120
Los Angeles, CA 90024-7002
Phone (310) 390-4099

2336 Santa Monica Blvd
Suite 304
Santa Monica, CA 90404-2067
Phone (310) 998-4747

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

Merit-based Incentive Payment System (MIPS)

Final score
80.82 of 100Reported as group
Quality
61.6
Promoting interoperability
100
Improvement activities
40
Cost
71.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A101388CAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California Surgical Oncology CurrentSince Jan 1, 2024 Accepting new patients
UCLA Medical Group Surgery Past Accepting new patients
Ut MD Anderson Cancer Center Past Accepting new patients

Locations

100 Medical Plz
Los Angeles, CA 90095
Phone (310) 825-2631

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

Regents Of The University
Los Angeles, CA 90074

309 W Quinto St
Santa Barbara, CA 93105
Phone (805) 563-0041

Interoperability endpoints

  • Direct secure messaging: mteshome1220647@direct.uclahealth.org

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, 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": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1699963678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL PLAZA SUITE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900954009",
            "telephone_number": "310-825-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESHOME",
        "first_name": "MEDIGET",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P7360",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "A101388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "331808101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.