Individual provider Active NPI

Marielle Rose Terheyden, NP

  • Family Nurse Practitioner
  • Fairfield, CA
National Provider Identifier
1285266593
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95013749 Issued in CA
Practice address
2700 Low CT
Fairfield, CA 94534-9715
Phone
(707) 688-6251
NPI assigned
Feb 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95013749 CA Primary

Addresses

Primary practice location

2700 Low CT
Fairfield, CA 94534-9715

Mailing address

323 Rock Creek Way
Pleasant Hill, CA 94523-4715
Phone (707) 688-6251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200423002662 CA Practitioner - Nurse Practitioner 0648600114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2702 Low CT
Fairfield, CA 94534-9771
Phone (707) 432-2600

2720 Low CT
Fairfield, CA 94534-9771
Phone (707) 428-2731

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95013749CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Apr 6, 2020 Accepting new patients
Sutter Valley Medical Foundation Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Apr 6, 2020 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2700 Low Ct
Fairfield, CA 94534
Phone (707) 432-2500

2702 Low Ct
Fairfield, CA 94534
Phone (707) 432-2600

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

Interoperability endpoints

  • Direct secure messaging: mterheyden449053@hisp.ehr.sutterhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1285266593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 ROCK CREEK WAY",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234715",
            "telephone_number": "707-688-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 LOW CT",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945349715",
            "telephone_number": "707-688-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERHEYDEN",
        "first_name": "MARIELLE",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95013749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.