NPIMap

Individual provider Active NPI

John Patrick Lim Tejada, M.D.

  • Pulmonary Disease Physician
  • Greenwood, SC
National Provider Identifier
1801104559
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
37989 Issued in SC
Practice address
105 Vinecrest CT # 1000
Greenwood, SC 29646-8031
Phone
(864) 725-3350
Fax
(864) 725-3351
NPI assigned
Sep 15, 2010
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 37989 SC Primary

Addresses

Primary practice location

105 Vinecrest CT # 1000
Greenwood, SC 29646-8031

Mailing address

105 Vinecrest CT # 1000
Greenwood, SC 29646-8031
Phone (864) 725-3350

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jtejada127242@selfregional.direct-ci.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714001442 SC Practitioner - Pulmonary Disease 8224341615 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians

Practice addresses (Care Compare)

105 Vinecrest CT
Greenwood, SC 29646-8031

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37989SCMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group CurrentSince Aug 1, 2015 Accepting new patients
Self Regional Healthcare Pulmonary Disease CurrentSince Jan 1, 2026 Accepting new patients
Self Medical Group CurrentSince Aug 1, 2015 Accepting new patients
Self Medical Group Current Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Medical Group Past Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

75 Remittance Dr
Dept 6793
Chicago, IL 60675

75 Remittance Dr
Dept 6875
Chicago, IL 60675

105 Vinecrest Ct
#1000
Greenwood, SC 29646
Phone (864) 227-5240

105 Vinecrest Ct
Ste 1000
Greenwood, SC 29646
Phone (864) 227-5240

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: jtejada127242@selfregional.direct-ci.net

Organizations & group practices 9

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 7

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": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1801104559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 VINECREST CT # 1000",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296468031",
            "telephone_number": "864-725-3350",
            "fax_number": "864-725-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VINECREST CT # 1000",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296468031",
            "telephone_number": "864-725-3350",
            "fax_number": "864-725-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJADA",
        "first_name": "JOHN PATRICK",
        "middle_name": "LIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-15",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "37989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtejada127242@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "105 Vinecrest Ct # 1000",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296468031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.