Individual provider Active NPI

Jill J Tiongco, MD

  • Internal Medicine Physician
  • Carmel, CA
National Provider Identifier
1861442196
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C53805 Issued in CA
Practice address
275 The Crossroads
Suite a
Carmel, CA 93923-8684
Phone
(831) 718-9701
NPI assigned
May 10, 2006
Last updated
Sep 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C53805 CA Primary

Addresses

Primary practice location

275 The Crossroads
Suite a
Carmel, CA 93923-8684

Mailing address

275 The Crossroads
Suite a
Carmel, CA 93923-8684
Phone (831) 718-9701

Other identifiers 1

IdentifierTypeStateIssuer
928260MedicaidAZ

Other names 1

  • Jill Joanne Reyes Tiongco Former name

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
I20091106000447 CA Practitioner - Internal Medicine 6305819244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montage Medical GroupGroup PAC ID 6406901941, 125 clinicians

Practice addresses (Care Compare)

2 Upper Ragsdale Dr
BLDG a
Monterey, CA 93940-5736
Phone (831) 718-9701

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53805CAMDOrthodontics and Dentofacial Orthopedic Dentist
C53805CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montage Medical Group Internal Medicine CurrentSince Sep 2, 2009 Accepting new patients
Sun Health Corporation Past Accepting new patients
Banner del E Webb Medical Center Past Accepting new patients
Community Hospital of the Monterey Peninsula Past Accepting new patients

Locations

275 The Crossroads Blvd
Ste A
Carmel, CA 93923
Phone (831) 620-0296

100 Wilson Rd
Ste 100
Monterey, CA 93940
Phone (831) 242-8301

2 Upper Ragsdale Dr
Bldg A
Monterey, CA 93940
Phone (831) 333-3040

23845 Holman Hwy
Ste 210
Monterey, CA 93940
Phone (831) 620-0296

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1861442196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 THE CROSSROADS",
            "address_2": "SUITE A",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939238684",
            "telephone_number": "831-718-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 THE CROSSROADS",
            "address_2": "SUITE A",
            "city": "CARMEL",
            "state": "CA",
            "postal_code": "939238684",
            "telephone_number": "831-718-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIONGCO",
        "first_name": "JILL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C53805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "928260",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "REYES TIONGCO",
            "middle_name": "JOANNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Carmel, CA

Sources for this page

Verify at the official NPI Registry.