Individual provider Active NPI

Luis Teodoro Teopengco, M.D.

  • Family Medicine Physician
  • Porterville, CA
National Provider Identifier
1831266691
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A69192 Issued in CA
Practice address
26501 Avenue 140
W-2 RM. 2039
Porterville, CA 93257-9109
Phone
(559) 782-2448
Fax
(559) 782-2073
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A69192 CA Primary

Addresses

Primary practice location

26501 Avenue 140
W-2 RM. 2039
Porterville, CA 93257-9109

Mailing address

26501 Avenue 140
W-2 RM. 2039
Porterville, CA 93257-9109
Phone (559) 782-2448

Other identifiers 1

IdentifierTypeStateIssuer
00A691920MedicaidCA

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
I20040323001979 CA Practitioner - Family Practice 1557252988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26501 Ave
Suite 140
Porterville, CA 93257-9109
Phone (559) 782-2259

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of California - Department of Developmental Services Current Accepting new patients
State of California - Department of Developmental Services CurrentSince Oct 1, 2015 Accepting new patients
Agnews Community Clinic CurrentSince Oct 1, 2015 Accepting new patients
Long Term Care Medical Group, Inc CurrentSince Oct 15, 2019 Accepting new patients
Central California Emergency Medicine Physicians Family Medicine Past Accepting new patients

Locations

925 N Cornelia Ave
Fresno, CA 93706
Phone (559) 275-4785

685 W Alluvial Ave
Ste 103
Fresno, CA 93711
Phone (559) 274-6444

26501 Avenue 140
Rm 2039
Porterville, CA 93257
Phone (559) 782-2448

26501 Avenue 140
Porterville, CA 93257
Phone (559) 782-2222

680 E Merritt Ave
Tulare, CA 93274
Phone (209) 686-8581

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1831266691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26501 AVENUE 140",
            "address_2": "W-2 RM. 2039",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932579109",
            "telephone_number": "559-782-2448",
            "fax_number": "559-782-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26501 AVENUE 140",
            "address_2": "W-2 RM. 2039",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932579109",
            "telephone_number": "559-782-2448",
            "fax_number": "559-782-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEOPENGCO",
        "first_name": "LUIS",
        "middle_name": "TEODORO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A69192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A691920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

Verify at the official NPI Registry.