Active NPI
Brianna K Tebo
- Physician Assistant
- Rome, NY
National Provider Identifier
1730944117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 032210
- Practice address
- 1500 N James St
Rome, NY 13440-2844 - Phone
- (315) 338-7184
- Fax
- (315) 339-1975
- NPI assigned
- Feb 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 032210 | NY | Primary |
Addresses
Primary practice location
1500 N James St
Rome, NY 13440-2844
Mailing address
245 Avery LN
Rome, NY 13441-4237
Phone (315) 337-1200
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 N James St
Rome, NY 13440-2844
Phone (315) 338-7184
Hospital & facility affiliations
- Nascentia Health at Home
- Rome Memorial Hospital, Inc
- Wynn Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032210 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rome Memorial Hospital, Inc. | Current | Accepting new patients | |
| Rome Memorial Hospital, Inc. | Past | Accepting new patients |
Locations
1500 N James St
Rome, NY 13440
Phone (315) 338-7000
Interoperability endpoints
- btebo@rmhclinics.medentdirect.com
Organizations & group practices 2
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.
-
- Psychiatric Hospital Unit
- Rome, NY
- NPI 1255315305
-
- Skilled Nursing Facility
- Rome, NY
- NPI 1528042264
Hospital & facility affiliations 10
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Utica, NY
- NPI 1205877172
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Rome, NY
- NPI 1306807193
Hospital
-
- General Acute Care Hospital
- Rome, NY
- NPI 1376546440
-
- Home Health Agency
- Syracuse, NY
- NPI 1265437982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1730944117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 AVERY LN",
"city": "ROME",
"state": "NY",
"postal_code": "134414237",
"telephone_number": "315-337-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 N JAMES ST",
"city": "ROME",
"state": "NY",
"postal_code": "134402844",
"telephone_number": "315-338-7184",
"fax_number": "315-339-1975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEBO",
"first_name": "BRIANNA",
"middle_name": "K",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-15",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "032210",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rome, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.