Individual provider Active NPI

Christopher K Tiner, MD

  • Specialist
  • Pasadena, CA
National Provider Identifier
1720095235
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A87203 Issued in CA
Practice address
50 Bellefontaine St
Suite 304
Pasadena, CA 91105-3132
Phone
(626) 788-9152
Fax
(626) 658-8917
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A87203 CA Primary

Addresses

Primary practice location

50 Bellefontaine St
Suite 304
Pasadena, CA 91105-3132

Mailing address

50 Bellefontaine St
Suite 304
Pasadena, CA 91105-3132
Phone (626) 788-9152

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
I20060928000357 CA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Maxillofacial Surgery 0042215865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: Maxillofacial Surgery
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Bellefontaine St
Pasadena, CA 91105-3132
Phone (626) 788-9152

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy12
Melanoma (skin cancer) excision16
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A87203CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pasadena Hosptial Association, LTD. CurrentSince Feb 15, 2010 Accepting new patients
Pasadena Hospital Association, LTD. CurrentSince Feb 15, 2010 Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients

Locations

711 Fairmount Ave
Pasadena, CA 91105
Phone (626) 397-3366

1044 S Fair Oaks Ave
Ste 101
Pasadena, CA 91105
Phone (626) 449-4859

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

50 Bellefontaine St
Ste 304
Pasadena, CA 91105
Phone (626) 788-9152

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488326400000",
    "number": "1720095235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BELLEFONTAINE ST",
            "address_2": "SUITE 304",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053132",
            "telephone_number": "626-788-9152",
            "fax_number": "626-658-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BELLEFONTAINE ST",
            "address_2": "SUITE 304",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053132",
            "telephone_number": "626-788-9152",
            "fax_number": "626-658-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINER",
        "first_name": "CHRISTOPHER",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2017-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A87203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.