Individual provider Active NPI

Keala Rae Tekolste, M.D.

  • Family Medicine Physician
  • Springfield, PA
National Provider Identifier
1306004510
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD442674 Issued in PA
Practice address
100 W Sproul Rd
Suite 120
Springfield, PA 19064-2033
Phone
(610) 338-1800
Fax
(610) 338-1809
NPI assigned
May 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD442674 PA Primary

Addresses

Primary practice location

100 W Sproul Rd
Suite 120
Springfield, PA 19064-2033

Mailing address

100 W Sproul Rd
Suite 120
Springfield, PA 19064-2033
Phone (610) 338-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110822000377 PA Practitioner - Family Practice 7911177308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

255 W Lancaster Ave
Paoli, PA 19301-1763
Phone (610) 644-9233

Hospital & facility affiliations

  • Main Line Health Home Care & Hospice - Home Health Home health agency, Radnor, PA, CCN 397012
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Bryn Mawr Rehabilitation Hospital Inpatient rehabilitation facility, Malvern, PA, CCN 393025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD442674PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Health Access Network, Inc. Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Main Line Healthcare Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Prospect Health Access Network, Inc. Family Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

250 W Lancaster Ave
Ste 340
Paoli, PA 19301
Phone (610) 407-9000

255 W Lancaster Ave
Ste 330
Paoli, PA 19301
Phone (484) 565-1600

100 W Sproul Rd
Ste 120
Springfield, PA 19064
Phone (610) 338-1800

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

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.

Hospital & facility affiliations 5

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": "1211760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342051200000",
    "number": "1306004510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W SPROUL RD",
            "address_2": "SUITE 120",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642033",
            "telephone_number": "610-338-1800",
            "fax_number": "610-338-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W SPROUL RD",
            "address_2": "SUITE 120",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190642033",
            "telephone_number": "610-338-1800",
            "fax_number": "610-338-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKOLSTE",
        "first_name": "KEALA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-26",
        "last_updated": "2012-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD442674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, PA

Sources for this page

Verify at the official NPI Registry.