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DR. NICHOLAS STEPHEN TEODORO MD
NPI 1225527922
Obstetrics & Gynecology in Lake Grove, NY

Active since May 08, 2018PECOS EnrolledAccepts Medicare Assignment
4 SMITH HAVEN MALL STE 1, LAKE GROVE, NY 11755(631) 444-4686(631) 444-4622 Get Directions Write a Review

NPPES record last updated: August 12, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 12, 2025, May 8, 2018 (2 updates tracked since 2018).

About Dr. Nicholas Stephen Teodoro Md NPPES

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

DR. NICHOLAS STEPHEN TEODORO MD (NPI 1225527922) is an individual obstetrics & gynecology provider in Lake Grove, New York, licensed in New York (318989) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, is affiliated with Suny/stony Brook University Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1225527922
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. NICHOLAS STEPHEN TEODOROCredential: MD
Location Address4 SMITH HAVEN MALL STE 1Lake Grove, NY 11755-1219
Mailing Address101 Nicolls Rd # Hsc8Stony Brook, NY 11794-0001
Phone(631) 444-4686
Fax(631) 444-4622
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateMay 8, 2018
Last NPPES UpdateAugust 12, 20252 updates tracked since enumeration
NPPES CertifiedAugust 12, 2025
✔ NPI 1225527922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in NY · 318989
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
4 SMITH HAVEN MALL STE 1, Lake Grove, NY 11755
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicholas Stephen Teodoro Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648525170
PECOS Enrollment IDI20250710002786
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.

Medicare Billing Reassignment

Medicare enrollment records show Nicholas Teodoro reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Associates In Obstetrics & Gynecology, University Faculty P
3.6 mi
Obstetrics & Gynecology
100 NICOLLS RD, SUNY @ STONY BROOK HSC, L9, RM 020
Stony Brook, NY 11794
  • Reassigned Medicare billing, New York enrollment
  • 125 clinicians in this Medicare group
NPI 1538114723 (631) 444-2731

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Suny/Stony Brook University Hospital

Acute Care Hospitals · Stony Brook, NY
4/5 CMS rating
OwnershipGovernment - State
CMS Certification Number330393
LocationHealth Sciences Center SunyStony Brook, NY 11794 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11755 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicholas Teodoro's NPI number?

The NPI number for Nicholas Teodoro is 1225527922. It was assigned to this individual provider in the NPPES registry on May 8, 2018.

Where is Nicholas Teodoro located?

Nicholas Teodoro practices at 4 Smith Haven Mall Ste 1, Lake Grove, NY 11755. The listed phone number is (631) 444-4686.

What is Nicholas Teodoro's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Nicholas Teodoro enrolled in Medicare?

Yes. Nicholas Teodoro is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Nicholas Teodoro's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicholas Teodoro reassigns Medicare benefits to University Associates In Obstetrics & Gynecology, University Faculty P (Stony Brook, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicholas Teodoro's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Nicholas Teodoro affiliated with any hospitals?

According to CMS data, Nicholas Teodoro is affiliated with Suny/Stony Brook University Hospital.

When was this NPI record last updated?

The NPPES record for Nicholas Teodoro was last updated on August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.