Individual provider Active NPI

Osvaldo Tejeiro, M.D.

  • Internal Medicine Physician
  • Jackson Heights, NY
National Provider Identifier
1689782575
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
141421 Issued in NY
Practice address
3723 91St St
Jackson Heights, NY 11372-7927
Phone
(718) 458-4013
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 141421 NY Primary

Addresses

Primary practice location

3723 91St St
Jackson Heights, NY 11372-7927

Mailing address

3723 91St St
Jackson Heights, NY 11372-7927
Phone (718) 458-4013

Other identifiers 1

IdentifierTypeStateIssuer
00465623MedicaidNY

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
I20120118000158 NY Practitioner - Internal MedicinePractitioner - Pulmonary Disease 6305013228 Practice locations: Jackson Heights, NY

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3723 91St St
Jackson Heights, NY 11372-7927
Phone (718) 458-4013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
141421NYMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: osvaldo.tejeiro@osvaldotejeiromd.ehi.direct-ci.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689782575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 91ST ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727927",
            "telephone_number": "718-458-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3723 91ST ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727927",
            "telephone_number": "718-458-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJEIRO",
        "first_name": "OSVALDO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "141421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00465623",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.