Michael Russell Tekautz, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G42730 Issued in CA

Practice address

1524 McHenry Ave
Suite 100
Modesto, CA 95350-4500

Phone

(209) 577-4444

Fax

(209) 527-2069

NPI assigned

Jun 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Cost

84.14

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Modesto Radiological Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Modesto, CA
  • NPI 1992747547

  Body Imaging

  Medicare reassignment NPD
• Turlock Imaging Services, LLC

  • Radiology Clinic/Center
  • Turlock, CA
  • NPI 1295279859
  Medicare reassignment NPD
• Modesto Radiology Imaging, Inc.

  • Diagnostic Radiology Physician
  • Modesto, CA
  • NPI 1588954929
  NPD

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1821033861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PARK AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953540556",
            "telephone_number": "209-571-6622",
            "fax_number": "209-527-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "SUITE 100",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-577-4444",
            "fax_number": "209-527-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKAUTZ",
        "first_name": "MICHAEL",
        "middle_name": "RUSSELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "G42730",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G42730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G427300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trinity Rose Teicheira
• Lisa Teixeira
• Michaela Teixeira
• Ariana Tejeda Rodriguez
• Jennifer Samantha Tejeda, BACHELORS
• Telecare Corporation (Telecare Behavioral Health Services Team)
• Telecare Corporation (Telecare Transitional Age Youth Behavioral Health Service Team)
• Telecare Corporation (Outreach and Engagement 3)
• Ameena Lexssa Tellez
• Christian Raquel Tellez, HEARING AID DISPENSE

• Diagnostic Radiology Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.