Individual provider Active NPI

Theresa Hetzler, MD

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1619978293
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
042.0013055 Issued in VT
Practice address
505 E 70TH St
New York, NY 10021-4872
Phone
(212) 746-3303
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 042.0013055 VT Primary
Pediatrics Physician 208000000X 181118 NY

Addresses

Primary practice location

505 E 70TH St
New York, NY 10021-4872

Mailing address

505 E 70TH St
New York, NY 10021-4872
Phone (212) 746-3303

Other identifiers 1

IdentifierTypeStateIssuer
01263758MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100204000716 NY Practitioner - Pediatric Medicine 6305989930 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042.0013055VTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell CurrentSince Aug 6, 2018 Accepting new patients
Weill Medical College of Cornell Pediatrics Current Accepting new patients
Weill Medical College of Cornell Pediatrics CurrentSince Aug 6, 2018 Accepting new patients
Cornell University Medical College Past Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients

Locations

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

505 E 70th St
New York, NY 10021
Phone (212) 746-2900

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: thh9024@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1619978293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-746-3303",
            "fax_number": "212-746-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E 70TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214872",
            "telephone_number": "212-746-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZLER",
        "first_name": "THERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "042.0013055",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "181118",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01263758",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.