Individual provider Active NPI

Stanley Bruce Teplick, MD

  • Ophthalmology Physician
  • Beaverton, OR
National Provider Identifier
1740288133
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD 19317 Issued in OR
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

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
128426MedicaidOR

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

LicenseStateTypeSpecialty
MD 19317ORMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew 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

  • FHIR API: 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.

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.

Verify at the official NPI Registry.