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TEODORO P. NISSEN M.D., INC
NPI 1629248109
Specialist in Vallejo, CA

Active since March 11, 2008CLIA 05D2007926 · Waiver
1460 N CAMINO ALTO STE 201, VALLEJO, CA 94589(707) 645-7210(707) 645-7249 Get Directions Write a Review

NPPES record last updated: February 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Teodoro P. Nissen M.d., Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEODORO P. NISSEN M.D., INC (NPI 1629248109) is a healthcare organization registered as a specialist in Vallejo, California and active in the NPI registry since March 2008. The organization holds a CLIA Waiver certificate valid through August 17, 2026 and lists Teodoro Pedro Nissen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1629248109
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameTEODORO P. NISSEN M.D., INC
Location Address1460 N CAMINO ALTO STE 201Vallejo, CA 94589-2567
Mailing Address1460 N Camino Alto Ste 201Vallejo, CA 94589-2567 · (707) 645-7210 · Fax (707) 645-7249
Phone(707) 645-7210
Fax(707) 645-7249
Organization SubpartNo
Authorized OfficialTeodoro Pedro NissenCeo · (707) 645-7210
Enumeration DateMarch 11, 2008
Last NPPES UpdateFebruary 12, 2026
NPPES CertifiedFebruary 12, 2026
✔ NPI 1629248109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · A77901
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1460 N CAMINO ALTO STE 201, Vallejo, CA 94589
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Other Names 1

Other NameBay Area Orthopedic Surgery And Sports Medicine

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Kansas City, Medica, Sanford Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2007926

Teodoro P Nissen MD Inc Bay Area Orthorpedic Surgery And Sports Medicine · Vallejo, CA
Active · expires Aug 17, 2026
CLIA Number05D2007926
Laboratory TypePhysician Office
Certificate Effective DateAugust 18, 2024
Certificate Expiration DateAugust 17, 2026
Laboratory DirectorTeodoro P. Nissen
Laboratory Phone(707) 645-7210
Laboratory LocationTeodoro P Nissen MD Inc Bay Area Orthorpedic Surgery And Sports Medicine100 Hospital Drive # 303, Vallejo, CA 94589
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TEODORO P NISSEN M.D.
Orthopaedic Surgery
1460 N CAMINO ALTO STE 201
VALLEJO, CA 94589
Napa County (707) 645-7210

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Teodoro P. Nissen M.D., Inc's NPI number?

The NPI number for Teodoro P. Nissen M.D., Inc is 1629248109. It was assigned to this organization in the NPPES registry on March 11, 2008. The provider is also known as Bay Area Orthopedic Surgery and Sports Medicine.

Where is Teodoro P. Nissen M.D., Inc located?

Teodoro P. Nissen M.D., Inc is located at 1460 N Camino Alto Ste 201, Vallejo, CA 94589. The listed phone number is (707) 645-7210.

What is Teodoro P. Nissen M.D., Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Teodoro P. Nissen M.D., Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2007926) is associated with this NPI, valid through August 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Teodoro P. Nissen M.D., Inc accept?

Health plans from Blue Cross and Blue Shield of Kansas City, Medica and Sanford Health Plan list Teodoro P. Nissen M.D., Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Teodoro P. Nissen M.D., Inc was last updated on February 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.