Individual provider Active NPI

Tapeesh Kansal, MD

  • Psychiatry Physician
  • San Bernardino, CA
National Provider Identifier
1841291408
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C52158 Issued in CA
Practice address
2080 S E St
San Bernardino, CA 92408-2773
Phone
(909) 388-9191
NPI assigned
Aug 4, 2005
Last updated
Jul 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X C52158 CA Primary

Addresses

Primary practice location

2080 S E St
San Bernardino, CA 92408-2773

Mailing address

2080 S E St
San Bernardino, CA 92408-2773
Phone (951) 642-9674

Other practice location 1

5225 Canyon Crest Dr Ste 103 Bldg 100
Riverside, CA 92507-6353
Phone (951) 248-4000

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
I20090130000534 CA Practitioner - Psychiatry 7113816455 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Heritage Medical Group IncGroup PAC ID 7517284029, 62 clinicians

Practice addresses (Care Compare)

1805 Medical Ctr Dr
San Bernardino, CA 92411-1217
Phone (818) 518-9715

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52158CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center Inc CurrentSince Jan 14, 2019 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatry CurrentSince Oct 1, 2019 Accepting new patients
Asana Integrated Medical Group PC Psychiatry CurrentSince Mar 1, 2015 Accepting new patients
Pacific Heritage Medical Group Inc CurrentSince Feb 1, 2015 Accepting new patients
Unicare Community Health Center Inc Current Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatry Current Accepting new patients
Telecare Corporation Current Accepting new patients
Telecare Corporation CurrentSince Feb 18, 2014 Accepting new patients
Inland Psychiatric Medical Group, Inc Psychiatry CurrentSince Oct 1, 2019 Accepting new patients
Telecare Corporation PastSince Aug 1, 2020 Accepting new patients
Telecare Corporation PastSince Feb 16, 2020 Accepting new patients
County of Monroe PastSince Oct 14, 2019 Accepting new patients
County of Monroe Past Accepting new patients

Locations

1080 Marina Village Pkwy
Ste 100
Alameda, CA 94501
Phone (510) 306-5660

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

12555 Central Ave
Ste C
Chino, CA 91710
Phone (909) 613-0100

308 N La Cadena Dr
Colton, CA 92324
Phone (909) 321-0700

23110 Atlantic Cir
Ste F
Moreno Valley, CA 92553
Phone (951) 243-6455

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

8710 Monroe Ct
Ste 150
Rancho Cucamonga, CA 91730
Phone (909) 941-4870

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

431 Mackay Dr
Ste 100
San Bernardino, CA 92408
Phone (909) 433-9300

1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333

2101 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 881-4305

3625 E Thousand Oaks Blvd
Ste 232
Westlake Village, CA 91362
Phone (818) 518-9715

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 14

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.

View all 14

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": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1841291408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 S E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082773",
            "telephone_number": "951-642-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 S E ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082773",
            "telephone_number": "909-388-9191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5225 Canyon Crest Dr Ste 103 Bldg 100",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925076353",
            "country_code": "US",
            "telephone_number": "951-248-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANSAL",
        "first_name": "TAPEESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C52158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.