TERESA SIEFKE (MS, AGACNP-BC) – Gerontology Nurse Practitioner, NPI 1245699453
Gerontology Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for TERESA SIEFKE (MS, AGACNP-BC)
3170 KETTERING BLVD BLDG B3
MORAINE, OH 454391924
Phone: (937) 991-3188
Fax: (937) 223-9811
Type: Mailing
3535 Pentagon Blvd
Beavercreek, OH 454311705
Phone: (937) 702-4450
Type: Location
850 Tuck St
Lebanon, PA 170427477
Phone: (717) 272-8173
Fax: (717) 272-4029
Type: Location
2222 Philadelphia Dr
Dayton, OH 454061813
Phone: (937) 734-3683
Type: Location
3 Richland Medical Park Dr Ste 310
Columbia, SC 292036862
Phone: (803) 434-8323
Fax: (803) 434-8326
Type: Location
North Main Street, Englewood, Montgomery County, Ohio, 45322, United States
ENGLEWOOD, OH 454151180
Phone: (937) 208-8394
Fax: (937) 208-8388
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-03-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 6 Medicare enrollment records; no due dates published yet.
Enrollment records
6
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170412001845 | I | Nurse Practitioner | OH | TBD |
| I20211227000693 | I | Nurse Practitioner | IL | TBD |
| I20220629002504 | I | Nurse Practitioner | FL | TBD |
| I20240506000119 | I | Nurse Practitioner | AR | TBD |
| I20240913003447 | I | Nurse Practitioner | MO | TBD |
| I20250307003482 | I | Nurse Practitioner | SC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45439)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Geriatric Medicine, Hematology/Oncology | IL | |
| Nurse Practitioner | OH | |
| Hematology/Oncology, Internal Medicine | OH | |
| Radiation Oncology | OH | |
| Nurse Practitioner | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Orthopedic Surgery | OH | |
| Pulmonary Disease, Critical Care (Intensivists), Sleep Medicine | OH | |
| Physician Assistant | OH | |
| Hospitalist, Emergency Medicine | OH |
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