Active NPI
Roberto Tellez, MD
- Internal Medicine Physician
- Philadelphia, PA
National Provider Identifier
1376166553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD482291
- Practice address
- 3401 N Broad St
Philadelphia, PA 19140-5103 - Phone
- (800) 836-7536
- NPI assigned
- May 22, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MT220038 | PA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD482291 | PA | Primary |
Addresses
Primary practice location
3401 N Broad St
Philadelphia, PA 19140-5103
Mailing address
559 W Germantown Pike
East Norriton, PA 19403-4250
Other practice location 1
559 W Germantown Pike
East Norriton, PA 19403-4250
Phone (484) 622-1000
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD482291 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospitalist Medicine Physicians of Pennsylvania, P.C. | Internal Medicine | Current | Accepting new patients |
| Einstein Medical Center Montgomery | Past | Accepting new patients |
Locations
559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000
120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040
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
- Somerset, PA
- NPI 1639464308
-
- General Acute Care Hospital
- East Norriton, PA
- NPI 1104192590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747612800000",
"number": "1376166553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "559 W GERMANTOWN PIKE",
"city": "EAST NORRITON",
"state": "PA",
"postal_code": "194034250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405103",
"telephone_number": "800-836-7536"
}
],
"practiceLocations": [
{
"address_1": "559 W Germantown Pike",
"address_purpose": "LOCATION",
"city": "East Norriton",
"state": "PA",
"postal_code": "194034250",
"country_code": "US",
"telephone_number": "484-622-1000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TELLEZ",
"first_name": "ROBERTO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-22",
"last_updated": "2025-05-19",
"certification_date": "2025-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "PA",
"license": "MT220038",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD482291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.