Individual provider Active NPI

Angel E Tejeda, M.D.

  • Nephrology Physician
  • Hialeah, FL
National Provider Identifier
1710905914
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME0065366 Issued in FL
Practice address
4305 E 8TH Ave
Suite C
Hialeah, FL 33013-2465
Phone
(305) 693-6305
Fax
(305) 456-0082
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME0065366 FL Primary

Addresses

Primary practice location

4305 E 8TH Ave
Suite C
Hialeah, FL 33013-2465

Mailing address

4305 E 8TH Ave
Suite C
Hialeah, FL 33013-2465
Phone (305) 693-6305

Other identifiers 1

IdentifierTypeStateIssuer
376300501MedicaidFL

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
I20110803000551 FL Practitioner - NephrologyPractitioner - Internal Medicine 0244409506 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1475 W 49TH PL
Hialeah, FL 33012-3113
Phone (305) 558-2500

2001 W 66TH St
Hialeah, FL 33016-1801
Phone (305) 823-5000

4305 E 8TH Ave
Suite C
Hialeah, FL 33013-2465

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0065366FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tu Salud Medical Services Inc CurrentSince Dec 11, 2022 Accepting new patients

Locations

900 Park Centre Blvd
Ste 400A
Miami Gardens, FL 33169
Phone (305) 912-8603

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1710905914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 E 8TH AVE",
            "address_2": "SUITE C",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330132465",
            "telephone_number": "305-693-6305",
            "fax_number": "305-456-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 E 8TH AVE",
            "address_2": "SUITE C",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330132465",
            "telephone_number": "305-693-6305",
            "fax_number": "305-456-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJEDA",
        "first_name": "ANGEL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME0065366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376300501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.