Teresa T Etten, M.D.

Key facts

NPI

1265587224

Entity type

Individual (NPI type 1)

Primary specialty

Obstetrics & Gynecology Physician 207V00000X

License

40631 (CO)

Practice address

10103 Ridgegate Pkwy
Suite 200
Lone Tree, CO 80124-5520

Phone

(303) 788-6657

Fax

(303) 788-8837

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

No

Organizations & group practices 3

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.

• Healthone Clinic Services - Obstetrics and Gynecology LLC Obstetrics & Gynecology Physician · Aurora, CO · NPI 1831397215
  Medicare reassignment Care Compare group NPD CO · OBSTETRICS & GYNECOLOGY
• HCA Healthone LLC General Acute Care Hospital · Lone Tree, CO · NPI 1659325629
  NPD (past)
• Healthone Clinic Services LLC Obstetrics & Gynecology Physician · Aurora, CO · NPI 1023099371
  NPD (past) OBSTETRICS & GYNECOLOGY

Medicare Care Compare profile

Specialty

Obstetrics/Gynecology

Education

Loyola University of Chicago, Stritch School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthone Clinic Services - Obstetrics and Gynecology LLC (62 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: teresa.etten@hca3.eclinicaldirectplus.com

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 1, 2022.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1265587224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "SUITE 210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-788-6657",
            "fax_number": "303-788-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10103 RIDGEGATE PKWY",
            "address_2": "SUITE 200",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245520",
            "telephone_number": "303-788-6657",
            "fax_number": "303-788-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTEN",
        "first_name": "TERESA",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "40631",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "40631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76185273",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160059141",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TERESA.ETTEN@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "10103 Ridgegate Pkwy",
            "address_2": "SUITE 200",
            "city": "Lone Tree",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801245520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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