TRISTA JAMIE TEETS
NPI 1083441703
Nurse Practitioner - Family in Brockport, NY

Q: What is Trista Teets's NPI number?

The NPI number for Trista Teets is 1083441703. It was assigned to this individual provider in the NPPES registry on September 17, 2024.

Q: What is Trista Teets's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Trista Teets was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 17, 2024PECOS Enrolled

300 WEST AVE, BROCKPORT, NY 14420(585) 637-3905 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Trista Jamie Teets NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRISTA JAMIE TEETS (NPI 1083441703) is an individual family provider in Brockport, New York, licensed in New York (357548) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1083441703

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTRISTA JAMIE TEETS

Location Address300 WEST AVEBrockport, NY 14420-1118

Mailing Address174 Gary DrBrockport, NY 14420-2672 · (585) 485-3024

Phone(585) 637-3905

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateSeptember 17, 2024

Last NPPES UpdateJuly 31, 2025

NPPES CertifiedJuly 31, 2025

✔ NPI 1083441703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · 357548

Also ListedPediatricsTaxonomy 208000000X · License 751854-01 (NY)

300 WEST AVE, Brockport, NY 14420

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Trista Jamie Teets is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5193299493

PECOS Enrollment IDI20260707003904

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14420 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KAREN ALLEN RDH

Dental Hygienist