NPIMap

Individual provider Active NPI

Daniel Eric Tellem, DPM

  • Foot Surgery Podiatrist
  • Rochester, NY
National Provider Identifier
1588714042
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
006090 Issued in NY
Practice address
2236 Ridge Rd W
Rochester, NY 14626-2804
Phone
(585) 225-2290
Fax
(585) 225-1367
NPI assigned
Jan 10, 2007
Last updated
Nov 21, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 006090 NY Primary

Addresses

Primary practice location

2236 Ridge Rd W
Rochester, NY 14626-2804

Mailing address

2236 Ridge Rd W
Rochester, NY 14626-2804
Phone (585) 225-2290

Other identifiers 1

IdentifierTypeStateIssuer
02648144MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000109 NY Practitioner - Podiatry 3779523352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westside Podiatry Group LLCGroup PAC ID 3971543554, 3 clinicians

Practice addresses (Care Compare)

103 Canal Landing Blvd
Rochester, NY 14626-5108
Phone (585) 225-2290

2236 W Ridge Rd
Rochester, NY 14626-2804

919 Westfall Rd BLDG C
Suite 130
Rochester, NY 14618-2638
Phone (585) 506-9790

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue88
Removal of skin lesions154
Removal of nail tissue1750
Removal or shaving of skin growth165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Podiatry Group LLC Foot Surgery CurrentSince Jul 1, 2005 Accepting new patients
Westside Podiatry Group LLC Foot Surgery CurrentSince Jul 1, 2005 Accepting new patients

Locations

2236 W Ridge Rd
Rochester, NY 14626
Phone (585) 225-2290

Interoperability endpoints

  • Direct secure messaging: dtellem@westsidepodiatrygroup.medentdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1588714042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2236 RIDGE RD W",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146262804",
            "telephone_number": "585-225-2290",
            "fax_number": "585-225-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 RIDGE RD W",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146262804",
            "telephone_number": "585-225-2290",
            "fax_number": "585-225-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEM",
        "first_name": "DANIEL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "006090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02648144",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.