Individual provider Active NPI

Teresa L Martelli

  • Pediatrics Physician
  • Newburgh, IN
National Provider Identifier
1316367709
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01079149A Issued in IN
Practice address
4111 Gateway Blvd
Newburgh, IN 47630-8954
Phone
(812) 853-5300
Fax
(812) 858-4660
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01079149A IN Primary

Addresses

Primary practice location

4111 Gateway Blvd
Newburgh, IN 47630-8954

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170911000217 IN Practitioner - Pediatric Medicine 5890068050 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Pediatrics CurrentSince Sep 1, 2017 Accepting new patients
Deaconess Clinic, Inc Pediatrics CurrentSince Sep 1, 2017 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic, Inc Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4209 Gateway Blvd
Newburgh, IN 47630
Phone (812) 426-9855

4111 Gateway Blvd
Newburgh, IN 47630
Phone (812) 853-5300

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Interoperability endpoints

  • Direct secure messaging: tmartelli193367@direct.deaconess.com

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": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316367709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 GATEWAY BLVD",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476308954",
            "telephone_number": "812-853-5300",
            "fax_number": "812-858-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTELLI",
        "first_name": "TERESA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01079149A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.