Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Trista Jamie Teets

Individual provider Pediatrics Physician · NPI 1083441703

Trista Jamie Teets is a Nurse Practitioner in Brockport, New York. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2024
Specialties on file
2

Practice location Address checks out

300 W Ave
Brockport, NY 14420-1118
Phone: (585) 637-3905
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 357548 (NY)
Pediatrics Physician Taxonomy 208000000X · Licence 751854-01 (NY)

Record details

NPI number1083441703
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 17, 2024
Last updated in NPPESJuly 31, 2025
Certification dateJuly 31, 2025
Mailing address174 Gary Dr, Brockport, NY 14420-2672

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Brockport