Jeffrey Han Tavis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A102252 Issued in CA

Practice address

12900 Park Plaza Dr
Ste 150, Ms 7110
Cerritos, CA 90703-9329

Phone

(562) 741-4470

Fax

(562) 741-4479

NPI assigned

Jan 27, 2008

Last updated

Apr 17, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jeffrey.tavis.1@32527.direct.athenahealth.com
• Direct secure messaging: jeffrey.tavis.p1@direct.caremorewest.nextgenshare.com

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.

• Albion Medical Partners of California West P C

  dba CareMore Health Medical Partners West, PC

  • Internal Medicine Physician
  • Cerritos, CA
  • NPI 1073110607
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of California, Inc

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1184663965
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  NPD (past)
• Memorial Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1255523643
  NPD (past)

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

{
    "created_epoch": "1201392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1750568242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W 6TH ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823302",
            "telephone_number": "951-356-8500",
            "fax_number": "951-356-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR",
            "address_2": "STE 150, MS 7110",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-741-4470",
            "fax_number": "562-741-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVIS",
        "first_name": "JEFFREY",
        "middle_name": "HAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-27",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A102252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Tam, PHARMD
• Maramil Tamayo
• Brenda Zulema Tapia, LCSW
• Gabriela Tarin, LCSW
• Ronic Shenay Tatum, NP
• Cole Dior Taylor, MSW
• Lauren Taylor
• Patricia M Taylor, PSYCHOLOGIST
• Taylored Care Services LLC (Taylored Care)
• Teach Me 2 Play

• Internal Medicine Physician in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.