Active NPI
Tera Nikole Hetrick-Stein, M.D.
- Pediatrics Physician
- Latham, NY
National Provider Identifier
1366638173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 245727
- Practice address
- 10 Century Hill Dr Ste 5
Latham, NY 12110-2162 - Phone
- (518) 783-5563
- Fax
- (518) 782-1540
- NPI assigned
- Sep 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 245727 | NY | Primary |
Addresses
Primary practice location
10 Century Hill Dr Ste 5
Latham, NY 12110-2162
Mailing address
10 Century Hill Dr Ste 5
Latham, NY 12110-2162
Phone (518) 783-5563
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02928509 | Medicaid | NY |
Other names 1
- Mrs. Tera Nikole Hetrick-Stein
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 245727 | NY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shaker Pediatrics PC | Past | Accepting new patients | |
| Community Care Physicians, PC | Past | Accepting new patients |
Interoperability endpoints
- terahetrick@shakerpediatrics.medentdirect.com
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Latham, NY
- NPI 1023380714
-
- Pediatric Adolescent Medicine Physician
- Latham, NY
- NPI 1336156223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787011200000",
"number": "1366638173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CENTURY HILL DR STE 5",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102162",
"telephone_number": "518-783-5563",
"fax_number": "518-782-1540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CENTURY HILL DR STE 5",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102162",
"telephone_number": "518-783-5563",
"fax_number": "518-782-1540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HETRICK-STEIN",
"first_name": "TERA",
"middle_name": "NIKOLE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-15",
"last_updated": "2026-08-18",
"certification_date": "2026-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "245727",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02928509",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TERA",
"last_name": "HETRICK-STEIN",
"middle_name": "NIKOLE",
"prefix": "MRS.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.