Organization Active NPI

Nelson a Terzian MD PA

  • Urology Physician
  • Tavernier, FL
National Provider Identifier
1578859021
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME 47431 Issued in FL
Legal business name
NELSON A TERZIAN MD PA
Practice address
91550 Overseas Hwy
Suite #104
Tavernier, FL 33070-2506
Phone
(305) 853-7165
Fax
(305) 853-7166
NPI assigned
Jun 23, 2011
Last updated
Jun 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Authorized official

Name
Miss Jill E Callahan
Title
Office Manager
Phone
(305) 853-7165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X ME 47431 FL Primary

Addresses

Primary practice location

91550 Overseas Hwy
Suite #104
Tavernier, FL 33070-2506

Mailing address

P.O. Box 2668
Key Largo, FL 33037
Phone (305) 853-7165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110908001821 FL Part B Supplier - Clinic/Group Practice 4385814987 Receives reassigned benefits from 2 practitioners
Practice locations: Homestead, FL; Tavernier, FL

National Provider Directory

National Provider Directory

Locations

91550 Overseas Hwy
Ste 104
Tavernier, FL 33070
Phone (305) 853-7165

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1308787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308787200000",
    "number": "1578859021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2668",
            "city": "KEY LARGO",
            "state": "FL",
            "postal_code": "33037",
            "telephone_number": "305-853-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91550 OVERSEAS HWY",
            "address_2": "SUITE #104",
            "city": "TAVERNIER",
            "state": "FL",
            "postal_code": "330702506",
            "telephone_number": "305-853-7165",
            "fax_number": "305-853-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELSON A TERZIAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-23",
        "last_updated": "2011-06-23",
        "status": "A",
        "authorized_official_last_name": "CALLAHAN",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-853-7165",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME 47431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavernier, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.