Kristina M. Tervo, D.O.
Individual provider Active NPI Family Medicine Physician · Chittenango, NY
NPI 1659321024 · NPPES record last updated Mar 18, 2014
Key facts
- NPI
- 1659321024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 270560 (NY)
- Practice address
- 153 W Genesee St
Chittenango, NY 13037-1528 - Phone
- (315) 687-5100
- Fax
- (315) 687-0252
- NPI assigned
- May 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040512001375 | MI | Practitioner - Family Practice | 0941290001 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current |
Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients | |
| Henr Y Ford Health System | Family Medicine | Current |
Accepting new patients |
Locations
8391 Commerce Rd
Commerce Twp, MI 48382
Phone (248) 360-8100
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 270560 | NY | Yes |
Addresses
Primary practice location
153 W Genesee St
Chittenango, NY 13037-1528
Mailing address
153 W Genesee St
Chittenango, NY 13037-1528
Phone (315) 687-5100
Other providers in Chittenango, NY
- Sharon Schlueter
- Alyssa Christine Shute
- Hannah Sidebottom
- Stonehedge Aquisition Chittenango I, LLC
- Seth Lee Stucker
- Maria Thannhauser
- Sue Anne Thomas
- Joyce Tibbett
- Ola Marie Trieb
- Joseph Vieau III
All providers in Chittenango, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.