Individual provider Active NPI

Michael Guy Teneriello, MD

  • Gynecologic Oncology Physician
  • Austin, TX
National Provider Identifier
1801834809
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
K1694 Issued in TX
Practice address
6204 Balcones Dr
Austin, TX 78731-4214
Phone
(512) 302-1771
Fax
(512) 302-9774
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X K1694 TX Primary

Addresses

Primary practice location

6204 Balcones Dr
Austin, TX 78731-4214

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 6

IdentifierTypeStateIssuer
125745303MedicaidTX
125745302MedicaidTX
8R1566OtherTXBLUE CROSS OF TEXAS
125745307MedicaidTX
125745306MedicaidTX
125745301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050620000979 TX Practitioner - Gynecological Oncology 3577508688 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gynecological Oncology
Education
Icahn School of Medicine at Mount Sinai, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

6204 Balcones Dr
Austin, TX 78731-4214
Phone (512) 427-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K1694TXMDGynecologic Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Oct 1, 2015 Accepting new patients
Texas Oncology PA Gynecologic Oncology CurrentSince Sep 1, 1999 Accepting new patients
Texas Oncology PA Gynecologic Oncology CurrentSince Sep 1, 1999 Accepting new patients
Seton Family of Doctors CurrentSince Oct 1, 2015 Accepting new patients

Locations

4101 James Casey St
Ste 100
Austin, TX 78745
Phone (512) 447-2202

12221 Renfert Way
Ste 300
Austin, TX 78758
Phone (512) 873-8900

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

6204 Balcones Dr
Austin, TX 78731
Phone (512) 302-1771

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

1350 First Colony Blvd
Sugar Land, TX 77479
Phone (281) 276-3467

1700 W State Highway 6
Woodway, TX 76712
Phone (254) 399-0741

Interoperability endpoints

  • Direct secure messaging: michael.teneriello@txo.ikm.direct-ci.com

Organizations & group practices 4

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1801834809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-437-9605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6204 BALCONES DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314214",
            "telephone_number": "512-302-1771",
            "fax_number": "512-302-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENERIELLO",
        "first_name": "MICHAEL",
        "middle_name": "GUY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "TX",
            "license": "K1694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125745303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125745302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TEXAS",
            "identifier": "8R1566",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125745307",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125745306",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125745301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.