Jascha Oscar Teibel, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

007336 Issued in NY

Practice address

3010 Grand Ave
Waukegan, IL 60085-2321

Phone

(585) 703-6774

NPI assigned

Apr 19, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wyoming CountyGroup PAC ID 9335118967, 40 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jteibel@surgeryspecialists.medentdirect.com

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.

• Wyoming County

  • Emergency Medicine Physician
  • Warsaw, NY
  • NPI 1407060759
  Medicare reassignment Care Compare group NPD
• Jeffrey Teibel, DPM

  • Podiatrist
  • Spencerport, NY
  • NPI 1356398226
  Medicare reassignment
• Wyoming County

  • Internal Medicine Physician
  • Warsaw, NY
  • NPI 1184030017
  NPD
• Wyoming County

  • Rural Acute Care Hospital
  • Warsaw, NY
  • NPI 1316924913
  NPD
• Wyoming County

  • Surgery Physician
  • Warsaw, NY
  • NPI 1811385065
  NPD
• The Foot Doctor

  • Podiatrist
  • Spencerport, NY
  • NPI 1710933155
  NPD (past)

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

{
    "created_epoch": "1587254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1477173524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "585-703-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852321",
            "telephone_number": "585-703-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEIBEL",
        "first_name": "JASCHA",
        "middle_name": "OSCAR",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-19",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "007336",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "135.001087",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Tapia, MA
• Ricardo G Tapiador, DMD
• Diane K Taylor
• Kim Taylor
• Veronica Taylor, OTR/L
• Adela Tellez-Pulido
• Andres Tellez
• Vanessa Ellen Tello, RN
• Nong Thao
• The Illinois Medical Assistance Treatment Program LLC

• Podiatrist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; 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.