Individual provider Active NPI

Elena Victoria Tellez, D.O.

  • Internal Medicine Physician
  • Hialeah, FL
National Provider Identifier
1619532124
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS18764 Issued in FL
Practice address
2001 W 68TH St Ste 202
Hialeah, FL 33016-1801
Phone
(305) 364-2107
NPI assigned
May 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OS18764 FL Primary

Addresses

Primary practice location

2001 W 68TH St Ste 202
Hialeah, FL 33016-1801

Mailing address

4960 SW 72ND Ave Ste 406
Miami, FL 33155-5506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20221031002922 FL Practitioner - Internal MedicinePractitioner - Hospitalist 6103155338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HHA Associates LLCGroup PAC ID 2961839758, 125 clinicians

Practice addresses (Care Compare)

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 476-3911

Hospital & facility affiliations

  • Westside Regional Medical Center Hospital, Plantation, FL, CCN 100228
  • University Hospital and Medical Center Hospital, Tamarac, FL, CCN 100224

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HHA Associates LLC CurrentSince Jul 29, 2022 Accepting new patients

Locations

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

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.

Hospital & facility affiliations 2

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": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1619532124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 SW 72ND AVE STE 406",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331555506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 68TH ST STE 202",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161801",
            "telephone_number": "305-364-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLEZ",
        "first_name": "ELENA",
        "middle_name": "VICTORIA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS18764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.