Active NPI
Telly M. Barreta, MD
- Anatomic Pathology & Clinical Pathology Physician
- Charleston, WV
National Provider Identifier
1578529772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 17752
- Practice address
- 3200 Maccorkle Avenue SE
Pathology Department
Charleston, WV 25304 - Phone
- (304) 388-5550
- Fax
- (304) 388-4352
- NPI assigned
- Apr 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cytopathology Physician | 207ZC0500X | 17752 | WV | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 17752 | WV | Primary |
Addresses
Primary practice location
3200 Maccorkle Avenue SE
Pathology Department
Charleston, WV 25304
Mailing address
3200 Maccorkle Ave SE
Pathology Dept
Charleston, WV 25304
Phone (304) 388-5550
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17752 | WV | MD | Cytopathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camc Teays Valley Hospital Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Hurricane, WV
- NPI 1205031051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448236800000",
"number": "1578529772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 MACCORKLE AVE SE",
"address_2": "PATHOLOGY DEPT",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "25304",
"telephone_number": "304-388-5550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 MACCORKLE AVENUE SE",
"address_2": "PATHOLOGY DEPARTMENT",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "25304",
"telephone_number": "304-388-5550",
"fax_number": "304-388-4352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRETA",
"first_name": "TELLY",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2015-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "207ZC0500X",
"taxonomy_group": "",
"desc": "Pathology, Cytopathology",
"state": "WV",
"license": "17752",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "WV",
"license": "17752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.