Timothy L Tello, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

477 Issued in ND

Practice address

1221 W Divide Ave
Suite 1
Bismarck, ND 58501-1290

Phone

(701) 224-0661

Fax

(701) 224-0663

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Center of the Dakotas, PCGroup PAC ID 7911965041, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timtello@direct.revolutionehr.com

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.

• Eye Center of the Dakotas, PC

  • Clinic/Center
  • Bismarck, ND
  • NPI 1548360761

  Optometrist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346348000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W DIVIDE AVE",
            "address_2": "SUITE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011290",
            "telephone_number": "701-224-0661",
            "fax_number": "701-224-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W DIVIDE AVE",
            "address_2": "SUITE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011290",
            "telephone_number": "701-224-0661",
            "fax_number": "701-224-0663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLO",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60409",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Tello-Skjerseth, MD
• Abel E Tello, MD
• Anthony M Tello, MD
• Francisco A Tello III, DPM
• Ronald D Tello, MD
• Sheri Lee Ten Broek, DC
• Michelle Lynn Tepastte, M.D.
• Breanne Ternes, PSY S
• Katie A Tescher, PHARMD
• Kelsie Tescher

• Optometrist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Optometrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.