Individual provider Active NPI

Jonathan Peter Teubl, MD

  • Hospitalist Physician
  • Albany, NY
National Provider Identifier
1063673960
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
258018 Issued in NY
Practice address
315 S Manning Blvd
Albany, NY 12208-1707
Phone
(518) 525-1550
NPI assigned
Jun 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 258018 NY
Family Medicine Physician 207Q00000X 04-35678 KS
Hospitalist Physician 208M00000X 258018 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
Albany, NY 12208-1707

Mailing address

PO Box 14890
Albany, NY 12212-4890
Phone (518) 525-5634

Other practice location 1

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3300

Other practice location 2

707 N Emporia St
Wichita, KS 67214-3707
Phone (316) 858-3460

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20111027000416 NY Practitioner - Family Practice 3274706825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of Ny Upstate Medical University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Hospital of Troy, New YorkGroup PAC ID 6507770070, 258 clinicians
St Peters Hospital of the City of AlbanyGroup PAC ID 2668460072, 268 clinicians

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3554

315 S Manning Blvd
Albany, NY 12208-1707
Phone (518) 525-1550

Hospital & facility affiliations

  • Community Hospice, Inc, the Hospice, Albany, NY, CCN 331501
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-35678KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter'S Hospital of the City of Albany Family Medicine CurrentSince Aug 11, 2017 Accepting new patients
St. Peter'S Hospital of the City of Albany Family Medicine CurrentSince Aug 11, 2017 Accepting new patients
Samaritan Hospital of Troy, New York Family Medicine CurrentSince Feb 1, 2022 Accepting new patients

Locations

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Interoperability endpoints

  • Direct secure messaging: jteubl789176@direct.trinity-health.org

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1063673960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890",
            "telephone_number": "518-525-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Burdett Ave",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802466",
            "country_code": "US",
            "telephone_number": "518-271-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "707 N Emporia St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672143707",
            "country_code": "US",
            "telephone_number": "316-858-3460",
            "fax_number": "316-858-3458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEUBL",
        "first_name": "JONATHAN",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "258018",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-35678",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "258018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.