Individual provider Active NPI

Teresa Terezis, M.D.

  • Internal Medicine Physician
  • Raleigh, NC
National Provider Identifier
1245385574
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2002 00814 Issued in NC
Practice address
3900 Browning PL
Suite 101
Raleigh, NC 27609-6508
Phone
(919) 781-9650
Fax
(919) 781-3572
NPI assigned
Jan 25, 2007
Last updated
Aug 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2002 00814 NC Primary

Addresses

Primary practice location

3900 Browning PL
Suite 101
Raleigh, NC 27609-6508

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Other identifiers 2

IdentifierTypeStateIssuer
5919615MedicaidNC
2002 00814OtherNCLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tterezisklemes11962@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090115000354 NC Practitioner - Internal Medicine 0345303400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

3900 Browning PL
Suite 101
Raleigh, NC 27609-6529
Phone (919) 781-9650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2002 00814NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network Group Practices, LLC CurrentSince Apr 1, 2013 Accepting new patients
Unc Physicians Network Group Practices, LLC CurrentSince Apr 1, 2013 Accepting new patients
Unc Physicians Network Group Practices, LLC Internal Medicine Current Accepting new patients
Garner Family Practice PA Past Accepting new patients

Locations

1600 Perimeter Park Dr
Ste 225
Morrisville, NC 27560
Phone (919) 804-5064

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

3900 Browning Pl
Ste 101
Raleigh, NC 27609

Organizations & group practices 4

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1245385574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BROWNING PL",
            "address_2": "SUITE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096508",
            "telephone_number": "919-781-9650",
            "fax_number": "919-781-3572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEREZIS",
        "first_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2002 00814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919615",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2002 00814",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tterezisklemes11962@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "3900 Browning Pl",
            "address_2": "Suite 101",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276096508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.