Individual provider Active NPI

Michael William Tedaldi, M.D.

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1992169957
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A153708 Issued in CA
Practice address
333 City Blvd W
Suite 400
Orange, CA 92868-2903
Phone
(714) 456-6693
NPI assigned
Apr 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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 A153708 CA Primary

Addresses

Primary practice location

333 City Blvd W
Suite 400
Orange, CA 92868-2903

Mailing address

107 N Hall St Ste a
Visalia, CA 93291-5850
Phone (559) 429-4781

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
I20200730001516 CA Practitioner - Internal Medicine 8921422254 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Hospitalist Medical Group, IncGroup PAC ID 5395882351, 36 clinicians
Long Term Care Medical Group, IncGroup PAC ID 9032016068, 37 clinicians

Practice addresses (Care Compare)

400 W Mineral King Ave
Visalia, CA 93291-6237
Phone (559) 909-0264

4444 W Meadow Ave
Visalia, CA 93277-1652
Phone (559) 627-1241

Hospital & facility affiliations

  • Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057
  • Linwood Meadows Care Center Nursing home, Visalia, CA, CCN 555125

Merit-based Incentive Payment System (MIPS)

Final score
82.8 of 100Reported as group
Quality
72.52
Improvement activities
40
Cost
59.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153708CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Hospitalist Medical Group, Inc CurrentSince Jun 15, 2020 Accepting new patients

Locations

400 W Mineral King Ave
Visalia, CA 93291
Phone (559) 624-2001

107 N Hall St
Ste A
Visalia, CA 93291
Phone (559) 302-5600

Organizations & group practices 2

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 2

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1992169957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N HALL ST STE A",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915850",
            "telephone_number": "559-429-4781",
            "fax_number": "559-623-9745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD W",
            "address_2": "SUITE 400",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682903",
            "telephone_number": "714-456-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDALDI",
        "first_name": "MICHAEL",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A153708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.