Tegan Donnelley, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · New York, NY
NPI 1992324503 · NPPES record last updated Feb 1, 2024
Key facts
- NPI
- 1992324503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 525 E 68TH St
New York, NY 10065-4870 - Phone
- (212) 746-5454
- NPI assigned
- Apr 14, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Previously, effective Sep 3, 2024 through Sep 3, 2026
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 311458 | NY | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
525 E 68TH St
New York, NY 10065-4870
Mailing address
525 E 68TH St FL 11
New York, NY 10065-4870
Other providers in New York, NY
- Donna R. Kesselman MD, PC
- Donna Zapin OT PC
- Christine Donnellan
- Robert Donnellan
- Naomi Strachan Donnelley
- Amanda Donnelly
- Anna Donnelly
- Colleen Donnelly
- Conor Donnelly
- James G Donnelly
All providers in New York, NY · Student in an Organized Health Care Education/Training Program in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.