Kelly Eileen Teagle, D.O.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

70417 Issued in CT

Practice address

21 Elm St
New Milford, CT 06776-2915

Phone

(203) 739-7038

NPI assigned

Apr 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, CT2 enrollments

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 2

Specialty

Gastroenterology

Education

New York College of Osteo Medicine of New York Institute of Technology, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Danbury Hospital Hospital, Danbury, CT, CCN 070033

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Nuvance Health Medical Practice CT, Inc.

  • Internal Medicine Physician
  • Danbury, CT
  • NPI 1407898117
  Medicare reassignment Care Compare group NPD
• Our Lady of Lourdes Memorial Hospital Inc.

  • General Acute Care Hospital
  • Binghamton, NY
  • NPI 1629087580
  Medicare reassignment NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Family Medicine Physician
  • Binghamton, NY
  • NPI 1063557189

  Internal Medicine

  NPD
• Our Lady of Lourdes Memorial Hospital, Inc.

  • Specialty Pharmacy
  • Johnson City, NY
  • NPI 1730982596
  NPD
• Twin Tier Pathology Associates, PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Binghamton, NY
  • NPI 1770577470
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Danbury Hospital

  • Dental Clinic/Center
  • Danbury, CT
  • NPI 1003835935

  Hospital

  Care Compare affiliation
• Danbury Hospital

  • General Acute Care Hospital
  • Danbury, CT
  • NPI 1548293343
  Care Compare affiliation

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

{
    "created_epoch": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1992095483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ELM ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ELM ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067762915",
            "telephone_number": "203-739-7038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "161 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139054176",
            "country_code": "US",
            "telephone_number": "607-770-1155",
            "fax_number": "607-770-1968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Marges Way",
            "address_purpose": "LOCATION",
            "city": "Hopewell Junction",
            "state": "NY",
            "postal_code": "125335002",
            "country_code": "US",
            "telephone_number": "845-546-0788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEAGLE",
        "first_name": "KELLY",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-18",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "70417",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "278898",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelly.teagle@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "161 Riverside Dr",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "139054176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan N Grammatico DNP FNP LLC
• John R. Sussman, M.D.
• Patrick Joseph Tannone, RPH
• Karen V Tarbell, MD
• Ginger Taylor, A.P.R.N
• Jonathan Terman, PHYSICAL THERAPIST
• Jacqueline Texidor, LCSW
• Puneet Thakur
• The Stop & Shop Supermarket Company LLC
• Stephanie Teresa Tiso, M.D.

• Gastroenterology Physician in New Milford, CT
• Providers in New Milford, CT by specialty
• Gastroenterology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.