Individual provider Active NPI

Ara M Tekerlek, DC

  • Sports Physician Chiropractor
  • Stockton, CA
National Provider Identifier
1881625515
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
18665 Issued in CA
Practice address
8829 Davis Rd Ste 1
Stockton, CA 95209-1871
Phone
(209) 474-3764
Fax
(209) 474-0506
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 18665 CA Primary

Addresses

Primary practice location

8829 Davis Rd Ste 1
Stockton, CA 95209-1871

Mailing address

8829 Davis Rd Ste 1
Stockton, CA 95209-1871
Phone (209) 474-3764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090428000034 CA Practitioner - Chiropractic 4183772387 Practice locations: Stockton, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8829 Davis Rd
Stockton, CA 95209-1871
Phone (209) 474-3764

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18665CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TJW Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881625515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8829 DAVIS RD STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952091871",
            "telephone_number": "209-474-3764",
            "fax_number": "209-474-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8829 DAVIS RD STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952091871",
            "telephone_number": "209-474-3764",
            "fax_number": "209-474-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKERLEK",
        "first_name": "ARA",
        "middle_name": "M",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "18665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.