| Michael Russell Tekautz, MD | |
|
1524 Mchenry Ave, Suite 100, Modesto, CA 95350-4500 | |
| (209) 577-4444 | |
| (209) 527-2069 |
| Full Name | Michael Russell Tekautz |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 1524 Mchenry Ave, Modesto, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821033861 | NPI | - | NPPES |
| 00G427300 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085B0100X | Radiology - Body Imaging | G42730 (California) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | G42730 (California) | Primary |
| Entity Name | Modesto Radiological Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992747547 PECOS PAC ID: 2062300239 Enrollment ID: O20040513000453 |
| Entity Name | Turlock Imaging Services, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295279859 PECOS PAC ID: 3678850922 Enrollment ID: O20170515001875 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Russell Tekautz, MD 101 Park Ave, Modesto, CA 95354-0556 Ph: (209) 571-6622 | Michael Russell Tekautz, MD 1524 Mchenry Ave, Suite 100, Modesto, CA 95350-4500 Ph: (209) 577-4444 |
Eric Chau-yong Ku, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1700 Coffee Rd, Modesto, CA 95355 Phone: 209-572-7237 |
Dr. Scott Alan Alexander, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-943-2041 Fax: 209-473-9365 |
Robert Ralph Anderson, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1524 Mchenry Ave, Suite 100, Modesto, CA 95350 Phone: 209-577-4444 Fax: 209-527-2069 |
Rafael Vargas, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-550-4755 Fax: 209-521-3970 |
Kevin Tae Il Whang, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1524 Mchenry Ave, Modesto, CA 95350 Phone: 209-577-4444 Fax: 209-527-2069 |
Paul Jonathan Ramirez, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1524 Mchenry Ave, Suite 430, Modesto, CA 95350 Phone: 209-577-4444 Fax: 209-846-7309 |
Arka Dutta, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 600 Coffee Rd, Modesto, CA 95355 Phone: 209-550-4755 Fax: 209-521-3970 |