Active NPI
Tere Hope Dickson, MD, MPH
- Pediatrics Physician
- Rosedale, NY
National Provider Identifier
1144492505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 236629-1
- Practice address
- 241-08 140TH Ave
Rosedale, NY 11422-2022 - Phone
- (718) 949-0146
- NPI assigned
- Mar 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 236629-1 | NY | |
| Pediatrics Physician | 208000000X | 236629-1 | NY | Primary |
Addresses
Primary practice location
241-08 140TH Ave
Rosedale, NY 11422-2022
Mailing address
241-08 140TH Ave
Rosedale, NY 11422-2022
Phone (718) 949-0146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12085134 | Other | CAQH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236629-1 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1144492505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "241-08 140TH AVE",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114222022",
"telephone_number": "718-949-0146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "241-08 140TH AVE",
"city": "ROSEDALE",
"state": "NY",
"postal_code": "114222022",
"telephone_number": "718-949-0146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKSON",
"first_name": "TERE",
"middle_name": "HOPE",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-26",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "NY",
"license": "236629-1",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "236629-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12085134",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.