Teeranun Jirajariyavej, M.D.
Individual provider Active NPI Internal Medicine Physician · Nipomo, CA
NPI 1730317751 · NPPES record last updated Jan 11, 2019
Key facts
- NPI
- 1730317751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 118478 (CA)
- Practice address
- 150 Tejas PL
Nipomo, CA 93444-9123 - Phone
- (805) 929-3211
- Fax
- (805) 929-6359
- NPI assigned
- Jun 29, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Endocrinology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Centers of the Central Coast Inc
Practice addresses (Care Compare)
150 Tejas PL
Nipomo, CA 93444-9123
Phone (805) 929-3211
2801 Santa Maria Way
Santa Maria, CA 93455-2118
Hospital & facility affiliations
- Marian Regional Medical Center
- French Hospital Medical Center
- Adventist Health Sierra Vista
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170807003467 | CA | Practitioner - Endocrinology | 4486877933 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118478 | CA | MD | Marriage & Family Therapist |
| 36669 | SC | MD | Family Medicine Physician |
| A118478 | CA | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Centers of the Central Coast Inc | Current | Accepting new patients | |
| Aristamd | Internal Medicine | Current |
Accepting new patients |
| Community Health Centers of the Central Coast Inc | Current |
Accepting new patients | |
| Community Health Centers of the Central Coast Inc | Current | Accepting new patients | |
| Community Health Centers of the Central Coast Inc | Current |
Accepting new patients | |
| Community Health Centers of the Central Coast Inc | Current | Accepting new patients |
Locations
150 Tejas Pl
Nipomo, CA 93444
Phone (805) 929-3254
4755 Nexus Center Dr
San Diego, CA 92121
Phone (858) 750-4777
2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8014
325 Posada Ln
Templeton, CA 93465
Phone (805) 239-0644
Interoperability endpoints
- teeranun.jirajariyavej.1@17363.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | A118478 | CA | |
| Internal Medicine Physician | 207R00000X | 118478 | CA | Yes |
Addresses
Primary practice location
150 Tejas PL
Nipomo, CA 93444-9123
Mailing address
2050 S Blosser Rd
Santa Maria, CA 93458
Phone (805) 361-8028
Other providers in Nipomo, CA
- Leslie Diane Huitron
- Mark Christopher Interian
- Alexander Irvine
- Janet B. Gaussoin
- Trey Stephen Jangaard
- Malia Lynn Johnson
- Maya Johnson
- Janelle Suzanne Jost
- Atipon Kangwanpornsiri
- Kassandra Boortz, LMFT, LLC
All providers in Nipomo, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.