Individual provider Active NPI

Geoffrey Stephan Teehan, M.D.

  • Nephrology Physician
  • Wynnewood, PA
National Provider Identifier
1558366237
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD426100 Issued in PA
Practice address
100 E Lancaster Ave Ste 130
Wynnewood, PA 19096-3453
Phone
(610) 649-1175
Fax
(610) 896-8753
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD426100 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave Ste 130
Wynnewood, PA 19096-3453

Mailing address

100 E Lancaster Ave Ste 130
Wynnewood, PA 19096-3453
Phone (610) 649-1175

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gteehan11953@direct.acumenmd.com

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050808000408 PA Practitioner - Nephrology 4486620739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Jefferson Medical College of Thomas Jefferson University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kidney Care Specialists LLCGroup PAC ID 9931450079, 41 clinicians

Practice addresses (Care Compare)

1001 Reed Ave
Suite 410
Reading, PA 19610-2731
Phone (610) 258-3608

609 W Germantown Pike
Suite 210
East Norriton, PA 19403-4251
Phone (610) 649-1175

824 Main St
Suite 203
Phoenixville, PA 19460-4478
Phone (610) 649-1175

Hospital & facility affiliations

  • FKC Overbrook Dialysis facility, Philadelphia, PA, CCN 392781
  • FKC Wynnewood Dialysis facility, Wynnewood, PA, CCN 392539
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Mercy Catholic Medical Center- Mercy Fitzgerald Hospital, Darby, PA, CCN 390156

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Care Specialists LLC Nephrology CurrentSince Apr 29, 2019 Accepting new patients
Valley Kidney Specialists, PC Nephrology CurrentSince Jun 2, 2018 Accepting new patients
Valley Kidney Specialists, P.C. Nephrology CurrentSince Jun 2, 2018 Accepting new patients
Emerson Hospital Past Accepting new patients

Locations

1230 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 432-4873

2000 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 356-3700

100 E Lancaster Ave
Ste 164E
Wynnewood, PA 19096

100 E Lancaster Ave
Bldg W
Wynnewood, PA 19096
Phone (610) 642-8555

100 E Lancaster Ave
Ste 130W
Wynnewood, PA 19096

100 E Lancaster Ave
Ste 130
Wynnewood, PA 19096
Phone (610) 649-8089

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1558366237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 130",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963453",
            "telephone_number": "610-649-1175",
            "fax_number": "610-896-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 130",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963453",
            "telephone_number": "610-649-1175",
            "fax_number": "610-896-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEHAN",
        "first_name": "GEOFFREY",
        "middle_name": "STEPHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "MD426100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gteehan11953@direct.acumenmd.com",
            "affiliation": "N",
            "address_1": "100 E Lancaster Ave Ste 130",
            "city": "Wynnewood",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190963453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.