BRUKE TEDLA – Adult Congenital Heart Disease Physician, NPI 1982102539

BRUKE TEDLA is a healthcare provider. based in Los angeles, California. specializing in CARDIOVASCULAR DISEASE (CARDIOLOGY). They hold a License No. A160609 (CA). The NPI Number for BRUKE TEDLA is 1982102539

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
BRUKE TEDLA
NPI
1982102539
Phone
Not provided
Address
4650 W SUNSET BLVD
Enumeration Date
29 January 2018
Last Update Date
11 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2017 (9 years ago)
PAC ID
8426545336
Group Practice PAC ID
1153227814
Professional Enrollment ID
I20251014003770
Address ID
CA923543450LO11370STXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness85
Years active:8State licenses:1Digital endpointsOther names

3,010 CARDIOVASCULAR DISEASE (CARDIOLOGY) in CA

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Provider Addresses for BRUKE TEDLA

  • West Sunset Boulevard, Hollywood, Los Angeles, Los Angeles County, California, 90028-8127, United States

    LOS ANGELES, CA 900276062

    Phone:

    Type: Mailing

  • 2068 ORANGE TREE LN STE 215

    REDLANDS, CA 923744555

    Phone:

    Type: Mailing

  • 11324 ANDERSON ST

    LOMA LINDA, CA 923501728

    Phone: (909) 558-8590

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251014003770ICardiovascular Disease (Cardiology)CATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 90027)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153227814View full group profile
NameSpecialtyState
-CA
-CA
-CA
O B S T E T R I C S/ G Y N E C O L O G YCA
Physician AssistantCA
Certified Registered Nurse Anesthetist (Crna)CA
Critical Care (Intensivists), General SurgeryCA
Surgical Oncology, General SurgeryIL
A N E S T H E S I O L O G YCA
Certified Registered Nurse Anesthetist (Crna)CA

Reviews

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Frequently asked questions

What unique ID ties claims to BRUKE TEDLA?
NPI 1982102539 is assigned to BRUKE TEDLA under the national enumeration system.
Does this profile mean BRUKE TEDLA is currently active?
Yes — BRUKE TEDLA appears active in the national provider directory.
What field does BRUKE TEDLA work in?
You can think of BRUKE TEDLA as practicing within Adult Congenital Heart Disease Physician. Clinical services aligned with this taxonomy classification.
Does BRUKE TEDLA practice in California?
You will see Los Angeles, California on file for BRUKE TEDLA alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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