Individual provider Active NPI

Eula Geralyn Plana Tetangco, M.D.

  • Gastroenterology Physician
  • Henderson, KY
National Provider Identifier
1639584014
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
54318 Issued in KY
Practice address
1305 N Elm St Ste G
Henderson, KY 42420-2783
Phone
(812) 426-9545
Fax
(812) 858-4512
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036.152601 IL
Gastroenterology Physician 207RG0100X 01084758A IN
Student in an Organized Health Care Education/Training Program 390200000X 077952 GA
Student in an Organized Health Care Education/Training Program 390200000X 125065611 IL
Gastroenterology Physician 207RG0100X 54318 KY Primary

Addresses

Primary practice location

1305 N Elm St Ste G
Henderson, KY 42420-2783

Mailing address

PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815

Other practice location 1

420 E Superior St
Chicago, IL 60611-4494
Phone (312) 926-7430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210728002992 KY Practitioner - Gastroenterology 3375853542 Reassigns benefits to 1 organization
I20210826001331 IN Practitioner - Gastroenterology 3375853542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, shared by 10 NPIs, 411 clinicians

Practice addresses (Care Compare)

1305 N Elm St
Suite G
Henderson, KY 42420-2783
Phone (812) 426-9545

4015 Gateway Blvd
Newburgh, IN 47630-8925
Phone (812) 858-9400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy108
Upper gastrointestinal (GI) endoscopy for acid reflux211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.152601ILMDGastroenterology Physician
54318KYMDGastroenterology Physician
077952GAMDStudent in an Organized Health Care Education/Training Program
125065611ILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic, Inc Gastroenterology CurrentSince Jul 23, 2021 Accepting new patients
Deaconess Clinic Inc Gastroenterology CurrentSince Jul 22, 2021 Accepting new patients
Deaconess Clinic, Inc Current Accepting new patients
Deaconess Clinic Inc CurrentSince Jul 22, 2021 Accepting new patients
Deaconess Clinic Inc. Gastroenterology Current Accepting new patients
Deaconess Clinic, Inc Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4015 Gateway Blvd
Newburgh, IN 47630
Phone (812) 858-6244

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1305 N Elm St
Ste G
Henderson, KY 42420
Phone (270) 826-0002

1700 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-0031

Interoperability endpoints

  • Direct secure messaging: etetangco226736@direct.deaconess.com

Organizations & group practices 6

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 6

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": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1639584014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061510",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N ELM ST STE G",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424202783",
            "telephone_number": "812-426-9545",
            "fax_number": "812-858-4512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606114494",
            "country_code": "US",
            "telephone_number": "312-926-7430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TETANGCO",
        "first_name": "EULA GERALYN",
        "middle_name": "PLANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036.152601",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01084758A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "077952",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125065611",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KY",
            "license": "54318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, KY

Sources for this page

Verify at the official NPI Registry.