Tin C. Botzler, MD
Individual provider Active NPI Internal Medicine Physician · Los Angeles, CA
NPI 1831491695 · NPPES record last updated Oct 15, 2021
Key facts
- NPI
- 1831491695
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A112613 (CA)
- Practice address
- 1200 N State St
Los Angeles, CA 90033-1029 - Phone
- (323) 409-7531
- NPI assigned
- Nov 30, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 17
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Providence Medical Foundation
United Indian Health Services, Inc.
Practice addresses (Care Compare)
1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210
1600 Weeot Way
Arcata, CA 95521-4734
Phone (707) 825-5000
200 W Ctr St Promenade
Anaheim, CA 92805-3960
2280 Harrison Ave
Eureka, CA 95501-3200
Phone (707) 443-9371
2332 23Rd St
Eureka, CA 95501-3231
Phone (707) 444-8011
2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 445-8121
2710 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 267-2060
2773 Harris St
Eureka, CA 95503-4866
3300 Renner Dr
Fortuna, CA 95540-3120
Phone (707) 725-3361
500 Doyle Park Dr
Santa Rosa, CA 95405-4559
Hospital & facility affiliations
- Providence St Joseph Hospital
- Providence Redwood Memorial Hospital
- Mad River Community Hospital
- Providence Santa Rosa Memorial Hospital
- Sutter Coast Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 68 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111214000887 | CA | Practitioner - Cardiovascular Disease (Cardiology) |
0143495499 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A112613 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current |
Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients | |
| California Hospitalists Emergency Physicians Medical Group Inc | Current |
Accepting new patients | |
| United Indian Health Services, Inc. | Current | Accepting new patients | |
| United Indian Health Services, Inc. | Current |
Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| United Indian Health Services, Inc. | Current |
Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Memorial Medical Group Inc | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805
1600 Weeot Way
Arcata, CA 95521
Phone (707) 825-5000
1200 Marshall St
Crescent City, CA 95531
Phone (707) 465-1126
2379 23rd St
Eureka, CA 95501
Phone (707) 443-9371
2505 Lucas St
#A
Eureka, CA 95501
Phone (707) 442-0380
2773 Harris St
Ste A
Eureka, CA 95503
Phone (707) 442-1182
2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229
2332 23rd St
Eureka, CA 95501
Phone (707) 444-2819
3304 Renner Dr
Fortuna, CA 95540
Phone (707) 725-4477
13222 Bloomfield Ave
Norwalk, CA 90650
Phone (562) 207-9729
1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210
500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842
Interoperability endpoints
- tbotzler813489@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A112613 | CA | Yes |
Addresses
Primary practice location
1200 N State St
Los Angeles, CA 90033-1029
Mailing address
4716 Jessica Dr
Los Angeles, CA 90065-4119
Phone (917) 558-2623
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tbotzler1657509@oc.providencedirect.org | ||
| Direct Messaging Address | tbotzler1657509@oc.providencedirect.org | ||
| Direct Messaging Address | tbotzler1657509@oc.providencedirect.org | ||
| Direct Messaging Address | tbotzler1657509@oc.providencedirect.org |
Other providers in Los Angeles, CA
- James Bottoms
- Madison Bottorff
- Michael Magdy Bottros
- Alyce Botwinick
- Charlotte Botz
- Michael Bouaziz
- Cynthia Boubion
- Houda Boucekkine
- Marcel Bouchard
- Heather Boucher
All providers in Los Angeles, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.