Organization Active NPI

Phillip Tse, MD Medical Corporation

  • Nephrology Physician
  • San Jose, CA
National Provider Identifier
1780155580
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
PHILLIP TSE, MD MEDICAL CORPORATION
Practice address
373 S Redwood Ave
San Jose, CA 95128-5109
Phone
(408) 261-3739
Fax
(408) 261-3737
NPI assigned
Dec 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Authorized official

Name
Dr. Phillip Tse, MDNPI 1184732901
Title
Ceo
Phone
(408) 373-6798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

373 S Redwood Ave
San Jose, CA 95128-5109

Mailing address

373 S Redwood Ave
San Jose, CA 95128-5109
Phone (408) 261-3739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190425002246 CA Part B Supplier - Clinic/Group Practice 3779825633 Receives reassigned benefits from 1 practitioner
Practice locations: San Jose, CA

National Provider Directory

National Provider Directory

Locations

373 S Redwood Ave
San Jose, CA 95128
Phone (408) 261-3739

266 N Jackson Ave
Ste 7
San Jose, CA 95116
Phone (408) 261-3739

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1780155580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 S REDWOOD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951285109",
            "telephone_number": "408-261-3739",
            "fax_number": "408-261-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 S REDWOOD AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951285109",
            "telephone_number": "408-261-3739",
            "fax_number": "408-261-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP TSE, MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "TSE",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-373-6798",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.