Individual provider Active NPI

Teofilo Isaul Vasquez

  • Adult Health Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1619836640
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
312501 Issued in NY
Practice address
11515 Sutphin Blvd
Jamaica, NY 11434-1020
Phone
(718) 765-6009
Fax
(347) 682-4302
NPI assigned
Jan 16, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 312501 NY Primary

Addresses

Primary practice location

11515 Sutphin Blvd
Jamaica, NY 11434-1020

Mailing address

PO Box 746087
Atlanta, GA 30374-6087
Phone (312) 733-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223001169 NY Practitioner - Nurse Practitioner 0547741183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Griffin Myers Medical PCGroup PAC ID 5294145017, 78 clinicians

Practice addresses (Care Compare)

11515 Sutphin Blvd
Jamaica, NY 11434-1020
Phone (718) 765-6009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
312501NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Griffin Myers Medical, P.C. CurrentSince Mar 16, 2026 Accepting new patients

Locations

455 Sutter Ave
Brooklyn, NY 11212
Phone (718) 765-6550

11515 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 659-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1768521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1619836640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746087",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11515 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114341020",
            "telephone_number": "718-765-6009",
            "fax_number": "347-682-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "TEOFILO",
        "middle_name": "ISAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-16",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "312501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.