Individual provider Active NPI

Teresa Karen Yelle, MSN

  • Women's Health Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1184832792
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN2369779 Issued in MA
Practice address
1290 Tremont St
Roxbury, MA 02120-3432
Phone
(617) 858-2434
Fax
(617) 989-3006
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN2369779 MA Primary

Addresses

Primary practice location

1290 Tremont St
Roxbury, MA 02120-3432

Mailing address

1290 Tremont St
Roxbury, MA 02120-3432
Phone (617) 858-2434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20241209000484 MA Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 5395271837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN2369779MAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
County of Larimer Past Accepting new patients
County of Larimer PastSince Jan 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tyelle604756@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1184832792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 TREMONT ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021203432",
            "telephone_number": "617-858-2434",
            "fax_number": "617-989-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TREMONT ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021203432",
            "telephone_number": "617-858-2434",
            "fax_number": "617-989-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELLE",
        "first_name": "TERESA",
        "middle_name": "KAREN",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MA",
            "license": "RN2369779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.