Active NPI
Stanley Bruce Teplick, MD
- Ophthalmology Physician
- Beaverton, OR
National Provider Identifier
1740288133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD 19317
- Practice address
- 9975 SW Nimbus Ave
Beaverton, OR 97008-7150 - Phone
- (503) 520-0800
- Fax
- (503) 520-0403
- NPI assigned
- Jul 11, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD 19317 | OR | Primary |
Addresses
Primary practice location
9975 SW Nimbus Ave
Beaverton, OR 97008-7150
Mailing address
9975 SW Nimbus Ave
Beaverton, OR 97008-7150
Phone (503) 520-0800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128426 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD 19317 | OR | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brint Vision Center Inc,. | Ophthalmology | Past | Accepting new patients |
| Retina Consultants, LLP | Ophthalmology | Past | Accepting new patients |
| Jeffrey Singer, MD (Apmc) | Ophthalmology | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 3
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.
-
- Ophthalmology Physician
- Salem, OR
- NPI 1528181674
-
- Ophthalmology Physician
- Metairie, LA
- NPI 1972530897
-
- Ophthalmology Physician
- Metairie, LA
- NPI 1861474702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392249600000",
"number": "1740288133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9975 SW NIMBUS AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970087150",
"telephone_number": "503-520-0800",
"fax_number": "503-520-0403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9975 SW NIMBUS AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970087150",
"telephone_number": "503-520-0800",
"fax_number": "503-520-0403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEPLICK",
"first_name": "STANLEY",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-11",
"last_updated": "2014-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OR",
"license": "MD 19317",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128426",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.