Individual provider Active NPI

Teresa Elizabeth Braell, RN

  • Registered Nurse
  • Honeoye Falls, NY
National Provider Identifier
1063575819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
3069741 Issued in NY
Practice address
811 Cheese Factory Road
Honeoye Falls, NY 14472-9208
Phone
(585) 582-1741
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3069741 NY Primary

Addresses

Primary practice location

811 Cheese Factory Road
Honeoye Falls, NY 14472-9208

Mailing address

34 Jacaranda Court
Penfield, NY 14526-2610
Phone (585) 377-4497

Other identifiers 1

IdentifierTypeStateIssuer
02063734MedicaidNY

Other names 1

  • Mrs. Teresa Elizabeth Shetty Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
3069741NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063575819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 JACARANDA COURT",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145262610",
            "telephone_number": "585-377-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CHEESE FACTORY ROAD",
            "city": "HONEOYE FALLS",
            "state": "NY",
            "postal_code": "144729208",
            "telephone_number": "585-582-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAELL",
        "first_name": "TERESA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "3069741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02063734",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "SHETTY",
            "middle_name": "ELIZABETH",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Honeoye Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.