Individual provider Active NPI

Teresa Deak

  • Emergency Medicine Physician
  • Grafton, OH
National Provider Identifier
1679701346
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
259893 Issued in NY
Practice address
11875 Castleton LN
Grafton, OH 44044-9701
Phone
(440) 452-9172
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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
Emergency Medicine Physician 207P00000X 259893 NY Primary

Addresses

Primary practice location

11875 Castleton LN
Grafton, OH 44044-9701

Mailing address

11875 Castleton LN
Grafton, OH 44044-9701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 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
I20160115002122 TX Practitioner - Emergency Medicine 8527215128 Reassigns benefits to 2 organizations
I20180413002208 AZ Practitioner - Emergency Medicine 8527215128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services PC Emergency Medicine CurrentSince Mar 7, 2018 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Oct 16, 2019 Accepting new patients
Tuba City Regional Health Care Corporation CurrentSince Oct 16, 2019 Accepting new patients
Ray Hubbard Emergency Physicians PLLC Emergency Medicine CurrentSince Dec 8, 2015 Accepting new patients
Tuba City Regional Health Care Corporation Emergency Medicine Current Accepting new patients
Ray Hubbard Emergency Physicians PLLC Emergency Medicine CurrentSince Dec 8, 2015 Accepting new patients
Emergency Professional Services PC Emergency Medicine CurrentSince Mar 7, 2018 Accepting new patients
Emergency Professional Services PC Emergency Medicine Current Accepting new patients
Oregon Trail Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1300 N 12th St
Ste 301
Phoenix, AZ 85006
Phone (602) 239-6968

6800 Scenic Dr
#1550
Rowlett, TX 75088
Phone (972) 412-2273

231 S Collins Rd
Sunnyvale, TX 75182
Phone (972) 203-6240

Organizations & group practices 9

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": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1679701346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11875 CASTLETON LN",
            "city": "GRAFTON",
            "state": "OH",
            "postal_code": "440449701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11875 CASTLETON LN",
            "city": "GRAFTON",
            "state": "OH",
            "postal_code": "440449701",
            "telephone_number": "440-452-9172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAK",
        "first_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "259893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, OH

Sources for this page

Verify at the official NPI Registry.