Individual provider Active NPI

Teresa Anne Antalek, FNP

  • Family Nurse Practitioner
  • Endwell, NY
National Provider Identifier
1457790370
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
337993 Issued in NY
Practice address
415 Hooper Rd
Endwell, NY 13760-3698
Phone
(607) 754-3863
Fax
(607) 754-5697
NPI assigned
Jun 25, 2013
Last updated
Oct 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 337993 NY Primary

Addresses

Primary practice location

415 Hooper Rd
Endwell, NY 13760-3698

Mailing address

415 Hooper Rd
Endwell, NY 13760-3698
Phone (607) 754-3863

Other names 1

  • Teresa Michalovic Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140320000937 NY Practitioner - Nurse Practitioner 1557592383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endwell Family Physicians LLPGroup PAC ID 9537063987, 26 clinicians

Practice addresses (Care Compare)

415 Hooper Rd
Endwell, NY 13760-3646
Phone (607) 754-3863

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.22 of 100Reported as group
Quality
78.62
Promoting interoperability
96
Improvement activities
40
Cost
68.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
337993NYMDLicensed Practical Nurse

Interoperability endpoints

  • Direct secure messaging: tantalek@efp.medentdirect.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1457790370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 HOOPER RD",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137603698",
            "telephone_number": "607-754-3863",
            "fax_number": "607-754-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 HOOPER RD",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137603698",
            "telephone_number": "607-754-3863",
            "fax_number": "607-754-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTALEK",
        "first_name": "TERESA",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "337993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "MICHALOVIC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Endwell, NY

Sources for this page

Verify at the official NPI Registry.