Individual provider Active NPI

Theodore M Teacher, MD

  • Neurology Physician
  • Mission Viejo, CA
National Provider Identifier
1871514729
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G45898 Issued in CA
Practice address
26691 Plaza
Suite 235
Mission Viejo, CA 92691-6329
Phone
(949) 364-9054
Fax
(949) 364-6171
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G45898 CA Primary

Addresses

Primary practice location

26691 Plaza
Suite 235
Mission Viejo, CA 92691-6329

Mailing address

26691 Plaza
Suite 235
Mission Viejo, CA 92691-6329
Phone (949) 364-9054

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ57376ZOtherCABLUE SHIELD

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
I20111206000830 CA Practitioner - Neurology 1850566688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Wake Forest University School of Medicine, 1978
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

26691 Plaza
Suite 235
Mission Viejo, CA 92691-6398
Phone (949) 364-9054

Hospital & facility affiliations

  • Abbot Homehealth Inc Home health agency, Rancho Cucamonga, CA, CCN 559502

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45898CAMDMarriage & Family Therapist
G45898CAMDNeurology Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1871514729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26691 PLAZA",
            "address_2": "SUITE 235",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916329",
            "telephone_number": "949-364-9054",
            "fax_number": "949-364-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26691 PLAZA",
            "address_2": "SUITE 235",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916329",
            "telephone_number": "949-364-9054",
            "fax_number": "949-364-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEACHER",
        "first_name": "THEODORE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G45898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ57376Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.