William Anthony Tellez IV

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA064030 Issued in PA

Practice address

255 W Lancaster Ave
Suite 331 Mob III
Paoli, PA 19301-1756

Phone

(610) 527-2232

NPI assigned

Sep 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paoli Hospital Hospital, Paoli, PA, CCN 390153

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group
• GSL Hospital

  • Urgent Care Clinic/Center
  • Pottsville, PA
  • NPI 1073256608

  Family Medicine

  Medicare reassignment NPD
• St. Luke'S Hosptial

  • Urgent Care Clinic/Center
  • Wind Gap, PA
  • NPI 1376965731

  Family Medicine

  Medicare reassignment NPD
• St. Luke'S Quakertown Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Quakertown, PA
  • NPI 1225052616
  Medicare reassignment NPD
• St. Luke'S Hospital

  • Urgent Care Clinic/Center
  • Bethlehem, PA
  • NPI 1740232719
  Medicare reassignment
• St. Luke'S Hospital Monroe Campus

  • Occupational Medicine Physician
  • Stroudsburg, PA
  • NPI 1609311257
  Medicare reassignment
• The Carbon-Schuylkill Community Hospital, Inc.

  • Emergency Medicine Physician
  • Coaldale, PA
  • NPI 1194891010
  Medicare reassignment
• Carbon-Schuylkill Community Hospital, Inc.

  • Physician Assistant
  • Coaldale, PA
  • NPI 1164726733
  NPD
• St Luke'S Hospital

  • General Acute Care Hospital
  • Easton, PA
  • NPI 1376339226
  NPD
• St. Luke'S Hospital - Anderson Campus

  • Psychiatric Hospital Unit
  • Easton, PA
  • NPI 1023689676
  NPD
• St. Luke'S Hospital Monroe Campus

  • Urgent Care Clinic/Center
  • East Stroudsburg, PA
  • NPI 1467175489

  Family Medicine

  NPD
• St. Luke'S Hosptial

  • Urgent Care Clinic/Center
  • Leesport, PA
  • NPI 1508685215

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1154045672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 W CHESTER PIKE STE 160",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732336",
            "telephone_number": "484-337-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "address_2": "SUITE 331 MOB III",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011756",
            "telephone_number": "610-527-2232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Woodglen Rd",
            "address_purpose": "LOCATION",
            "city": "Pottsville",
            "state": "PA",
            "postal_code": "179011324",
            "country_code": "US",
            "telephone_number": "272-639-5755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLEZ",
        "first_name": "WILLIAM",
        "middle_name": "ANTHONY",
        "name_suffix": "IV",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-28",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064030",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA006262",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine E Szarka, MD
• Ralitza Tacheva
• Angela Bianca Tarloski, CRNP, PMHNP
• George T Taylor IV, MD
• Michael G. Tecce, DO
• Julia V Tenthoff, CRNP
• Teresa a. Marlino M.D., LLC
• Lori Terlesky
• Raffi V Terzian, MD
• Ama Tettey-Fio, MD

• Physician Assistant in Paoli, PA
• Providers in Paoli, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.