Individual provider Active NPI

Heather Tellez

  • Optometrist
  • Philadelphia, PA
National Provider Identifier
1710691761
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003892 Issued in PA
Practice address
180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660
Phone
(215) 554-6222
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003892 PA Primary

Addresses

Primary practice location

180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660

Mailing address

180 W Girard Ave Ste 5
Philadelphia, PA 19123-1660

Other practice location 1

1501 N Broad St Ste 7
Philadelphia, PA 19122-3319
Phone (215) 866-1742

Other practice location 2

612 Washington Ave Unit 3
Philadelphia, PA 19147-4836
Phone (215) 599-2020

Other practice location 3

49 E City Ave # 10
Bala Cynwyd, PA 19004-2421
Phone (610) 206-3866

Other practice location 4

5597 Tulip St Ste B8
Philadelphia, PA 19124-1562
Phone (267) 360-6944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230302000612 PA Practitioner - Optometry 1153794789 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbison Eye Care LLCGroup PAC ID 7810223500, 7 clinicians

Practice addresses (Care Compare)

5597 Tulip St
Suite B8
Philadelphia, PA 19124-1562
Phone (267) 360-6944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OEG003892PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
New World Vision Center, Inc. Optometrist CurrentSince Feb 1, 2023 Accepting new patients
City Line Eye Care LLC Optometrist CurrentSince Feb 1, 2023 Accepting new patients
Harbison Eye Care LLC Optometrist CurrentSince Feb 1, 2023 Accepting new patients
Trend Eye Care LLC Optometrist CurrentSince Feb 1, 2023 Accepting new patients

Locations

49 E City Ave
#10
Bala Cynwyd, PA 19004
Phone (610) 206-3866

180 W Girard Ave
Ste 5
Philadelphia, PA 19123
Phone (215) 554-6222

612 Washington Ave
Unit 3
Philadelphia, PA 19147
Phone (215) 599-2020

1501 N Broad St
Ste 7
Philadelphia, PA 19122
Phone (215) 360-6944

5597 Tulip St
Ste B8
Philadelphia, PA 19124
Phone (267) 360-6944

612 Washington Ave
Ste 3
Philadelphia, PA 19147
Phone (215) 599-2020

Organizations & group practices 5

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1710691761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 W GIRARD AVE STE 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W GIRARD AVE STE 5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231660",
            "telephone_number": "215-554-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Broad St Ste 7",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191223319",
            "country_code": "US",
            "telephone_number": "215-866-1742",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 Washington Ave Unit 3",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191474836",
            "country_code": "US",
            "telephone_number": "215-599-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "49 E City Ave # 10",
            "address_purpose": "LOCATION",
            "city": "Bala Cynwyd",
            "state": "PA",
            "postal_code": "190042421",
            "country_code": "US",
            "telephone_number": "610-206-3866",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5597 Tulip St Ste B8",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191241562",
            "country_code": "US",
            "telephone_number": "267-360-6944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLEZ",
        "first_name": "HEATHER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.