Individual provider Active NPI

Raymond Teoh

  • Pediatrics Physician
  • Kyle, TX
National Provider Identifier
1609192228
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P6929 Issued in TX
Practice address
4100 Everett Dr Ste 400
Kyle, TX 78640-6147
Phone
(512) 295-1333
Fax
(512) 406-7327
NPI assigned
Apr 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P6929 TX Primary

Addresses

Primary practice location

4100 Everett Dr Ste 400
Kyle, TX 78640-6147

Mailing address

6210 E Highway 290
Austin, TX 78723-1142
Phone (512) 483-9596

Other practice location 1

1807 Slaughter Ln Ste 490
Austin, TX 78748-6237
Phone (512) 282-8967

Other identifiers 2

IdentifierTypeStateIssuer
316355203MedicaidTX
316355202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130708000538 TX Practitioner - Pediatric Medicine 4688814064 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Mar 1, 2018 Accepting new patients
Austin Regional Clinic, PA Pediatrics CurrentSince Mar 1, 2018 Accepting new patients
Seton Hospitalist Service Past Accepting new patients

Locations

4515 Seton Center Pkwy
Ste 215
Austin, TX 78759
Phone (512) 338-3802

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

6210 E Highway 290
Austin, TX 78723

1807 W Slaughter Ln
Ste 490
Austin, TX 78748
Phone (512) 282-8967

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

4100 Everett
Ste 400
Kyle, TX 78640
Phone (512) 295-1333

940 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 244-9024

Interoperability endpoints

  • Direct secure messaging: rteoh20139@arcmd.direct-ci.com

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": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1609192228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9596",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 EVERETT DR STE 400",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406147",
            "telephone_number": "512-295-1333",
            "fax_number": "512-406-7327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1807 Slaughter Ln Ste 490",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787486237",
            "country_code": "US",
            "telephone_number": "512-282-8967",
            "fax_number": "512-406-7351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEOH",
        "first_name": "RAYMOND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P6929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316355203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316355202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

Verify at the official NPI Registry.