MEDICARE: JEFF L TEIBEL DPM FOOT DOCTOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1982579009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFF L TEIBEL DPM FOOT DOCTOR

Provider Business Mailing Address
First Line	:	290 FOREST HILLS RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14625-1947
Country	:	US
Telephone Number	:	585-721-3668
Fax Number	:	585-385-9124

Provider Business Practice Location Address
First Line	:	85 S UNION ST STE 203
Second Line	:
City	:	SPENCERPORT
State	:	NY
Zip	:	14559-1264
Country	:	US
Telephone Number	:	585-721-3668
Fax Number	:	585-385-9124

Authorized Official
Title or Position	:	OWNER
Name	:	JEFFREY L TEIBEL
Credential	:	DPM
Telephone Number	:	585-721-3668

Provider Enumeration Date	:	10/08/2025
Last Update Date	:	10/08/2025

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