Tanya Dall, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A151283 Issued in CA

Practice address

30230 Rancho Viejo Rd Ste 134
San Juan Capistrano, CA 92675-1585

Phone

(949) 702-6736

NPI assigned

Apr 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, AZ2 enrollments

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 2

Specialty

Emergency Medicine

Education

Georgetown University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Renew Health Medical CorporationGroup PAC ID 3375063837, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Copper Queen Community Hospital Hospital, Bisbee, AZ, CCN 031312

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Renew Health Medical Corporation

  • Emergency Medicine Physician
  • San Juan Capistrano, CA
  • NPI 1629894324
  Medicare reassignment Care Compare group NPD Authorized official
• Mission Viejo Emergency Medical Associates

  • Emergency Medicine Physician
  • Mission Viejo, CA
  • NPI 1073542916
  Medicare reassignment NPD
• Mission Viejo Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Laguna Beach, CA
  • NPI 1134355597
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Bisbee Hospital Association

  • Critical Access Hospital
  • Bisbee, AZ
  • NPI 1518968767
  Medicare reassignment NPD
• Renew PC

  • Emergency Medicine Physician
  • San Juan Capistrano, CA
  • NPI 1386353126
  NPD Authorized official
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fullerton, CA
  • NPI 1336556059
  NPD
• Bisbee Hospital Association

  • Rural Health Clinic/Center
  • Hereford, AZ
  • NPI 1245986975
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bisbee Hospital Association

  • Critical Access Hospital
  • Bisbee, AZ
  • NPI 1518968767
  Care Compare affiliation

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

{
    "created_epoch": "1460160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1932563533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 SPUR ST",
            "city": "RMV",
            "state": "CA",
            "postal_code": "926941614",
            "telephone_number": "949-702-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30230 RANCHO VIEJO RD STE 134",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751585",
            "telephone_number": "949-702-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALL",
        "first_name": "TANYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-09",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A151283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "441 N Lakeview Ave",
            "city": "Anaheim",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928073028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donita Custard
• Terry D'Amico
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• Carol Lorraine Daderian, D.D.S.
• Jeremy Tait Dailey, LMFT, PHD
• Dan Hakjae Kim, a Professional Chiropractic Corp
• Dana Shores Recovery
• Daniel L Fortmann MD PC
• Sugganth Daniel, MD
• Dao Optometric Group

• Emergency Medicine Physician in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.