Individual provider Active NPI

Erena Treskova, MD

  • Pediatric Gastroenterology Physician
  • Middletown, NY
National Provider Identifier
1568404283
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
25MA06362400 Issued in NJ
Practice address
682 E Main St Ste 2D
Middletown, NY 10940-2647
Phone
(845) 341-0264
Fax
(845) 343-0962
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 25MA06362400 NJ Primary

Addresses

Primary practice location

682 E Main St Ste 2D
Middletown, NY 10940-2647

Mailing address

PO Box 18666
Belfast, ME 04915-4081
Phone (845) 341-0264

Other identifiers 1

IdentifierTypeStateIssuer
8259704MedicaidNJ

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA06362400NJMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
Trustees of Columbia University in the City of New York Pediatric Gastroenterology Past Accepting new patients
Erena Treskova and Co., LLC Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: erena.treskova@direct.hobokenumc.md
  • FHIR API: https://api.platform.athenahealth.com/1324/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1568404283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18666",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154081",
            "telephone_number": "845-341-0264",
            "fax_number": "845-343-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 E MAIN ST STE 2D",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402647",
            "telephone_number": "845-341-0264",
            "fax_number": "845-343-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRESKOVA",
        "first_name": "ERENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NJ",
            "license": "25MA06362400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8259704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.