Individual provider Active NPI

Sireesha Teegala, MD

  • Family Medicine Physician
  • Bellerose, NY
National Provider Identifier
1649777087
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T3398 Issued in TX
Practice address
8607 Commonwealth Blvd
Bellerose, NY 11426-1632
Phone
(917) 605-3305
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 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
Family Medicine Physician 207Q00000X T3398 TX Primary

Addresses

Primary practice location

8607 Commonwealth Blvd
Bellerose, NY 11426-1632

Mailing address

900 W Magnolia Ave Ste 201&203
Fort Worth, TX 76104-8517

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address steegala904509@direct.sw.org

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
I20220113001485 TX Practitioner - Family Practice 1658763198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

900 W Magnolia Ave
Suite 201
Fort Worth, TX 76104-8518
Phone (817) 921-6166

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Nov 22, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 22, 2021 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

900 W Magnolia Ave
Ste 201
Ft Worth, TX 76104
Phone (817) 921-6166

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: steegala1847864@direct.texashealth.org
  • Direct secure messaging: steegala904509@direct.sw.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1649777087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W MAGNOLIA AVE STE 201&203",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761048517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8607 COMMONWEALTH BLVD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261632",
            "telephone_number": "917-605-3305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEGALA",
        "first_name": "SIREESHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "steegala904509@direct.sw.org",
            "affiliation": "N",
            "address_1": "950 W Magnolia Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761044501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellerose, NY

Sources for this page

Verify at the official NPI Registry.