NPIMap

Individual provider Active NPI

Keven Tagdiri, M.D.

  • Internal Medicine Physician
  • Encinitas, CA
National Provider Identifier
1922000694
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A47779 Issued in CA
Practice address
4401 Manchester Ave
Suite 103
Encinitas, CA 92024-4938
Phone
(858) 756-3021
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2008

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 A47779 CA Primary

Addresses

Primary practice location

4401 Manchester Ave
Suite 103
Encinitas, CA 92024-4938

Mailing address

4401 Manchester Ave
Suite 103
Encinitas, CA 92024-4938
Phone (858) 756-3021

Other identifiers 1

IdentifierTypeStateIssuer
A47779OtherCAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091002000204 CA Practitioner - Internal Medicine 2365588431 Receives reassigned benefits from 1 practitioner
Practice locations: Encinitas, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4401 Manchester Ave
Suite 103
Encinitas, CA 92024-4938
Phone (858) 756-3021

Hospital & facility affiliations

  • Lorian Health Home health agency, San Diego, CA, CCN 058113
  • Archer Health Inc Home health agency, Carlsbad, CA, CCN 053124
  • Trio Home Health Care of San Diego Inc Home health agency, Encinitas, CA, CCN 059610
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503
  • Scripps Green Hospital Hospital, La Jolla, CA, CCN 050424

Merit-based Incentive Payment System (MIPS)

Final score
89.44 of 100Reported as individual
Quality
95.65
Promoting interoperability
100
Improvement activities
40
Cost
69.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A47779CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: keven.tagdiri.1@2034.direct.athenahealth.com
  • Direct secure messaging: ktagdiri37731@scrippshlth.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 3

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 5

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1922000694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244938",
            "telephone_number": "858-756-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MANCHESTER AVE",
            "address_2": "SUITE 103",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244938",
            "telephone_number": "858-756-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGDIRI",
        "first_name": "KEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A47779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "A47779",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.