Individual provider Active NPI

Eileen Ruth Teyim, CRNP

  • Nurse Practitioner
  • Plymouth Meeting, PA
National Provider Identifier
1770767014
Registry record updated Oct 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP015361 Issued in PA
Practice address
2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047
Phone
(610) 834-1122
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP015361 PA Primary

Addresses

Primary practice location

2250 Hickory Rd
Suite 240
Plymouth Meeting, PA 19462-1047

Mailing address

7440 Crane Xing
Macungie, PA 18062-2109

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161122001269 PA Practitioner - Nurse Practitioner 1658650296 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meribah Clinic LLCGroup PAC ID 1850794298, 2 clinicians

Practice addresses (Care Compare)

1005 Brookside Rd
Suite 240
Allentown, PA 18106-9023
Phone (610) 572-5659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Geropsych, LLC CurrentSince Apr 15, 2019 Accepting new patients
Meribah Clinic LLC CurrentSince Mar 31, 2021 Accepting new patients

Locations

1005 Brookside Rd
Ste 240
Allentown, PA 18106
Phone (610) 351-0419

4379 Easton Ave
#101
Bethlehem, PA 18020
Phone (610) 625-1486

428 S 7th St
Lehighton, PA 18235
Phone (610) 401-3559

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": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443744000000",
    "number": "1770767014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 CRANE XING",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180622109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD",
            "address_2": "SUITE 240",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621047",
            "telephone_number": "610-834-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEYIM",
        "first_name": "EILEEN",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2015-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP015361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.