Individual provider Active NPI

Alicia Nichole Telega, O.D.

  • Optometrist
  • Pittsburgh, PA
National Provider Identifier
1003988296
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG001865 Issued in PA
Practice address
5730 Ellsworth Ave
Suite 4
Pittsburgh, PA 15232-1741
Phone
(412) 404-2626
Fax
(412) 404-2446
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001621 VA
Optometrist 152W00000X OEG001865 PA Primary

Addresses

Primary practice location

5730 Ellsworth Ave
Suite 4
Pittsburgh, PA 15232-1741

Mailing address

5730 Ellsworth Ave
Suite 4
Pittsburgh, PA 15232-1741
Phone (412) 404-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140218000227 PA Practitioner - Optometry 8022110741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5730 Ellsworth Ave
Suite 4
Pittsburgh, PA 15232-1795
Phone (412) 404-2626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG001865PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shadyside Eye Associates. LLC Optometrist CurrentSince Nov 13, 2013 Accepting new patients

Locations

5730 Ellsworth Ave
Ste 4
Pittsburgh, PA 15232
Phone (412) 404-2626

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1003988296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 ELLSWORTH AVE",
            "address_2": "SUITE 4",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321741",
            "telephone_number": "412-404-2626",
            "fax_number": "412-404-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 ELLSWORTH AVE",
            "address_2": "SUITE 4",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152321741",
            "telephone_number": "412-404-2626",
            "fax_number": "412-404-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELEGA",
        "first_name": "ALICIA",
        "middle_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001621",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.