Individual provider Active NPI

Ricardo Mark Terlaje, M.D.

  • Family Medicine Physician
  • Tamuning, GU
National Provider Identifier
1154543874
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-1165 Issued in GU
Practice address
125 Carlos LN
Tamuning, GU 96913-4339
Phone
(671) 649-5052
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Family Medicine Physician 207Q00000X M-1165 GU Primary

Addresses

Primary practice location

125 Carlos LN
Tamuning, GU 96913-4339

Mailing address

PO Box 25566
Barrigada, GU 96921-5566
Phone (671) 649-5052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20130802000150 GU Practitioner - Family Practice 2365439577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Medical Center, LLCGroup PAC ID 1759311699, 17 clinicians

Practice addresses (Care Compare)

1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262

1244 N Marine Corps Dr
Tamuning, GU 96913-4308

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Medical Center, LLC CurrentSince Jul 15, 2019 Accepting new patients
Tumon Medical Office Family Medicine Past Accepting new patients

Locations

1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154543874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25566",
            "city": "BARRIGADA",
            "state": "GU",
            "postal_code": "969215566",
            "telephone_number": "671-649-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CARLOS LN",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134339",
            "telephone_number": "671-649-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERLAJE",
        "first_name": "RICARDO",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GU",
            "license": "M-1165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.