Individual provider Active NPI

Jordan Golubcow-Teglasi, MD

  • Internal Medicine Physician
  • White Plains, NY
National Provider Identifier
1043479603
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
248857-1 Issued in NY
Practice address
210 Westchester Ave
White Plains, NY 10604-2901
Phone
(914) 682-6530
Fax
(914) 681-5260
NPI assigned
Jun 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 248857-1 NY Primary

Addresses

Primary practice location

210 Westchester Ave
White Plains, NY 10604-2901

Mailing address

800 Westchester Ave Ste N715
Rye Brook, NY 10573-1369
Phone (914) 607-5730

Other identifiers 2

IdentifierTypeStateIssuer
248857OtherNYLICENSE
PENDINGMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090415000060 NY Practitioner - Internal Medicine 9335296078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Westchester Medical Group, P.CGroup PAC ID 6406752963, 410 clinicians

Practice addresses (Care Compare)

210 Westchester Ave
White Plains, NY 10604-2901
Phone (914) 682-0700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248857-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Group, P.C. Internal Medicine CurrentSince Feb 1, 2021 Accepting new patients
The Westchester Medical Group PC CurrentSince Feb 1, 2021 Accepting new patients

Locations

800 Westchester Ave
Ste N715
Rye Brook, NY 10573
Phone (914) 607-5730

210 Westchester Ave
White Plains, NY 10604
Phone (914) 681-3100

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: jordan.golubcow-teglasi.1@21260.direct.athenahealth.com

Organizations & group practices 3

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 3

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": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1043479603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WESTCHESTER AVE STE N715",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731369",
            "telephone_number": "914-607-5730",
            "fax_number": "914-457-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WESTCHESTER AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106042901",
            "telephone_number": "914-682-6530",
            "fax_number": "914-681-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUBCOW-TEGLASI",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-08",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "248857-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "248857",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.