Nicolas Jean Terentjev, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02008025A Issued in IN

Practice address

3000 S State Road 135 Ste 310
Greenwood, IN 46143-5527

Phone

(317) 497-2400

NPI assigned

Apr 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Family Practice

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital South, Inc. Hospital, Indianapolis, IN, CCN 150128

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: nterentjev562529@ecommunitydirect.com

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

• Community Hospital South, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1235109778
  Care Compare affiliation

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1992400600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 S STATE ROAD 135 STE 310",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461435527",
            "telephone_number": "317-497-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "533 E County Line Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461431074",
            "country_code": "US",
            "telephone_number": "317-957-9050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERENTJEV",
        "first_name": "NICOLAS",
        "middle_name": "JEAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11023196A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02008025A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300076861",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.