Active NPI
Heather Teitelbaum, PA-C
- Physician Assistant
- College Park, MD
National Provider Identifier
1235454711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0003207
- Practice address
- 140 Campus Dr
College Park, MD 20742-0001 - Phone
- (301) 314-2549
- NPI assigned
- Mar 29, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0003207 | MD | Primary |
Addresses
Primary practice location
140 Campus Dr
College Park, MD 20742-0001
Mailing address
140 Campus Dr
College Park, MD 20742-0001
Phone (301) 314-2549
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2016 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0003207 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Health Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- College Park, MD
- NPI 1508849639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1235454711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 CAMPUS DR",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207420001",
"telephone_number": "301-314-2549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 CAMPUS DR",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207420001",
"telephone_number": "301-314-2549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEITELBAUM",
"first_name": "HEATHER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-29",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0003207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.