Michelle Denise Tedja, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q2213 Issued in TX

Practice address

8901 Boone Rd
Houston, TX 77099-1659

Phone

(281) 454-0500

NPI assigned

Aug 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: michelle.tedja@blu.eclinicaldirectplus.com

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.

• Blue Fish Pediatrics, L.L.P.

  • Pediatrics Physician
  • Houston, TX
  • NPI 1891884508
  NPD (past)

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043566557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST STE JJL 495",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501",
            "telephone_number": "713-500-6645",
            "fax_number": "713-500-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 BOONE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770991659",
            "telephone_number": "281-454-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 Fannin St Ste 500",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770303005",
            "country_code": "US",
            "telephone_number": "832-325-7111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEDJA",
        "first_name": "MICHELLE",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q2213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "347829901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ted Care VI LLC
• Ted Care VII LLC
• Ted Care VIII LLC
• Felicia Tedder, LCSW
• Tedder'S Counseling Corner, PLLC
• Tesfamariam Mebrahtom Tedla, M.D.
• Melodie Alexandra Tedross, PA-C
• Francis Michael Tee, MD
• Purnima Sravanti Teegavarapu
• Teen and Family Services

• Pediatrics Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.