NPIMap

Individual provider Active NPI

Teresa M Mazur, MD

  • Emergency Medicine Physician
  • St Augustine, FL
National Provider Identifier
1013002864
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0066495 Issued in FL
Practice address
400 Health Park Blvd
St Augustine, FL 32086-5784
Phone
(904) 826-4700
Fax
(904) 346-0113
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0066495 FL Primary

Addresses

Primary practice location

400 Health Park Blvd
St Augustine, FL 32086-5784

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other identifiers 3

IdentifierTypeStateIssuer
26101OtherFLBCBS
P00331048OtherFLRAILROAD MEDICARE - FLAGL
376205000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WV, NM3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110809000192 GA Practitioner - Emergency Medicine 0446234918
I20190124003791 WV Practitioner - Emergency Medicine 0446234918 Reassigns benefits to 1 organization
I20191105001277 NM Practitioner - Emergency Medicine 0446234918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical School at Houston, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

6400 Paseo del Norte NE
Albuquerque, NM 87113-1718
Phone (505) 596-2100

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Nov 1, 2019 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Dec 1, 2018 Accepting new patients
Emanuel County Hospital Authority Current Accepting new patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients
St Luke'S Emergency Care Group LLC Emergency Medicine Past Accepting new patients
Cobblestone Emergency Physicians Emergency Medicine Past Accepting new patients
Emergency Physicians of St. Johns County Emergency Medicine Past Accepting new patients
Emergency Physicians Inc Emergency Medicine PastSince Jun 15, 2023 Accepting new patients
Florida Em-I Medical Services PA Emergency Medicine Past Accepting new patients
Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Belfort Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

6400 Paseo del Norte NE
Albuquerque, NM 87113
Phone (505) 596-2100

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

Interoperability endpoints

  • Direct secure messaging: tmazur152757@direct.phs.org

Organizations & group practices 12

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1013002864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-826-4700",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "TERESA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0066495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE - FLAGL",
            "identifier": "P00331048",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376205000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.