Tin C. Botzler, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A112613 Issued in CA

Practice address

1200 N State St
Los Angeles, CA 90033-1029

Phone

(323) 409-7531

NPI assigned

Nov 30, 2010

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 4

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

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

United Indian Health Services, Inc.Group PAC ID 9830085075, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
• Providence Redwood Memorial Hospital Hospital, Fortuna, CA, CCN 051318
• Mad River Community Hospital Hospital, Arcata, CA, CCN 050028
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbotzler1657509@oc.providencedirect.org
• Direct secure messaging: tbotzler813489@direct.ochin.org

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.

• United Indian Health Services, Inc.

  • Primary Care Clinic/Center
  • Arcata, CA
  • NPI 1497751572
  Medicare reassignment Care Compare group NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• California Hospitalists Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Norwalk, CA
  • NPI 1760648539
  Medicare reassignment NPD
• Providence Medical Foundation

  • Urology Physician
  • Apple Valley, CA
  • NPI 1053616706
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• United Indian Health Services, Inc.

  • Community Health Clinic/Center
  • Weitchpec, CA
  • NPI 1265438154
  NPD
• United Indian Health Services, Inc.

  • Community Health Clinic/Center
  • Arcata, CA
  • NPI 1699506121
  NPD
• Queen of the Valley Medical Association

  dba St Joseph Heritage Health System

  • Gynecology Physician
  • Napa, CA
  • NPI 1649260126
  NPD (past)
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  NPD (past)
• Memorial Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1255523643
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Hospital Management Corporation

  dba Mad River Community Hospital

  • General Acute Care Hospital
  • Arcata, CA
  • NPI 1518996040
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Redwood Memorial Hospital

  • Critical Access Hospital
  • Fortuna, CA
  • NPI 1043292303
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Redwood Memorial Hospital

  • Critical Access Hospital
  • Fortuna, CA
  • NPI 1285849026
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Humboldt Home Infusion

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence St. Joseph Hospital

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation
• Sutter Coast Hospital

  • General Acute Care Hospital
  • Crescent City, CA
  • NPI 1457367062
  Care Compare affiliation
• Sutter Coast Hospital

  dba Sutter Coast Community Clinic

  • General Practice Physician
  • Crescent City, CA
  • NPI 1700960267

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1831491695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 JESSICA DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900654119",
            "telephone_number": "917-558-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-409-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTZLER",
        "first_name": "TIN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-30",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A112613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbotzler1657509@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2773 Harris St Ste A",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955034866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbotzler1657509@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1200 Marshall St",
            "city": "Crescent City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955312217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbotzler1657509@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "3304 Renner Dr",
            "city": "Fortuna",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955407102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbotzler1657509@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2332 23rd St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955013231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Bottoms, MFT
• Madison Bottorff
• Michael Magdy Bottros, MD
• Alyce Botwinick, LCSW
• Charlotte Botz, MD
• Michael Bouaziz, MD
• Cynthia Boubion
• Houda Boucekkine, MD
• Marcel Bouchard, DMD
• Heather Boucher

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.