Individual provider Active NPI

Jeffrey C Territo, OD

  • Optometrist
  • Everett, PA
National Provider Identifier
1366422594
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000603 Issued in PA
Practice address
111 Fairview St
Everett, PA 15537-6337
Phone
(814) 623-2020
Fax
(814) 623-7816
NPI assigned
Jan 23, 2006
Last updated
Sep 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000603 PA Primary

Addresses

Primary practice location

111 Fairview St
Everett, PA 15537-6337

Mailing address

111 Fairview St
Everett, PA 15537-6337
Phone (814) 623-2020

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111101000612 PA Practitioner - Optometry 9931101680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brande Saad Group-BedfordGroup PAC ID 7810935202, 3 clinicians

Practice addresses (Care Compare)

111 Fairview St
Everett, PA 15537-6337
Phone (814) 623-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG000603PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brande Saad Group-Bedford Optometrist CurrentSince Mar 12, 1991 Accepting new patients

Locations

127 S Juliana St
Ste 4
Bedford, PA 15522
Phone (814) 623-2020

111 Fairview St
Everett, PA 15537
Phone (814) 623-2020

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1366422594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FAIRVIEW ST",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155376337",
            "telephone_number": "814-623-2020",
            "fax_number": "814-623-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FAIRVIEW ST",
            "city": "EVERETT",
            "state": "PA",
            "postal_code": "155376337",
            "telephone_number": "814-623-2020",
            "fax_number": "814-623-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRITO",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, PA

Sources for this page

Verify at the official NPI Registry.