Individual provider Active NPI

Samuel David Teles, MD

  • Emergency Medicine Physician
  • Riverside, CA
National Provider Identifier
1750969614
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
PTL7288 Issued in CA
Practice address
4445 Magnolia Ave
Riverside, CA 92501-4199
Phone
(951) 788-3000
NPI assigned
Mar 31, 2021
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X PTL7288 CA Primary

Addresses

Primary practice location

4445 Magnolia Ave
Riverside, CA 92501-4199

Mailing address

4445 Magnolia Ave
Riverside, CA 92501-4199
Phone (951) 788-3000

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
I20230301002704 CA Practitioner - Internal Medicine 8628441227 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Southern California Keck School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encinitas Emergency Medicine IncGroup PAC ID 1951711357, 42 clinicians
Singh MD a Professional MedicalGroup PAC ID 8426584988, 18 clinicians

Practice addresses (Care Compare)

354 Santa Fe Dr
Encinitas, CA 92024-5142
Phone (760) 753-1362

820 E Mountain View St
Barstow, CA 92311-3004
Phone (858) 863-7382

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.7 of 100Reported as group
Quality
81.57
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PTL7288CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chino Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Team Physicians of Southern California Medical Group, Inc. Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Singh MD a Professional Medical Emergency Medicine CurrentSince Dec 1, 2024 Accepting new patients
KND Development 59, LLC CurrentSince Jan 1, 2023 Accepting new patients
Encinitas Emergency Medicine, Inc. Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
KND Development 59 LLC Current Accepting new patients
KND Development 59, LLC CurrentSince Jan 1, 2023 Accepting new patients
MD Karan Singh Professional Corp Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

820 E Mountain View St
Barstow, CA 92311
Phone (760) 256-1761

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

354 Santa Fe Dr
Encinitas, CA 92024
Phone (760) 230-2251

4002 Vista Way
Oceanside, CA 92056
Phone (760) 724-8411

550 N Monterey Ave
Ontario, CA 91764
Phone (909) 629-2290

Organizations & group practices 8

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1750969614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014199",
            "telephone_number": "951-788-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014199",
            "telephone_number": "951-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELES",
        "first_name": "SAMUEL",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "PTL7288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.