Individual provider Active NPI

Rabebe Tekeraoi, MBBS, PGDIP &MMEDOPH

  • Ophthalmology Physician
  • Pago Pago, AS
National Provider Identifier
1780445056
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
5087C Issued in AS
Practice address
1 Paul Turner Drive
Pago Pago, AS 96799
Phone
(684) 633-1222
Fax
(684) 633-1839
NPI assigned
Jan 23, 2024
Last updated
Jan 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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 5087C AS Primary

Addresses

Primary practice location

1 Paul Turner Drive
Pago Pago, AS 96799

Mailing address

PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 633-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627000725 AS Practitioner - Ophthalmology 8224572698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5087CASMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Samoa Medical Center CurrentSince Apr 24, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1780445056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PAUL TURNER DRIVE",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "96799",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-1839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKERAOI",
        "first_name": "RABEBE",
        "name_prefix": "Dr.",
        "credential": "MBBS, PGDIP &MMEDOPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AS",
            "license": "5087C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pago Pago, AS

Sources for this page

Verify at the official NPI Registry.