Summer D Tewksbury, MD
Individual provider Active NPI Emergency Medicine Physician · Tuba City, AZ
NPI 1013138130 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1013138130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 41591 (AZ)
- Practice address
- 167 North Main Street
Tuba City, AZ 86045-0600 - Phone
- (928) 283-2501
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of Arizona College of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Northwest
Practice addresses (Care Compare)
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000
Hospital & facility affiliations
- Kaiser Foundation Hospital Westside
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160817003205 | OR | Practitioner - Emergency Medicine | 1759434392 | Reassigns benefits to 1 organization |
| I20210301002632 | WA | Practitioner - Emergency Medicine | 1759434392 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5315027390 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Emergency Medicine | Current |
Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients |
Locations
10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5315027390 | MI | |
| Emergency Medicine Physician | 207P00000X | 41591 | AZ | Yes |
Addresses
Primary practice location
167 North Main Street
Tuba City, AZ 86045-0600
Mailing address
PO Box 600
Tuba City, AZ 86045-0600
Phone (928) 283-2501
Other names
- Dr. Summer D Stears-Ellis
Other providers in Tuba City, AZ
- Tcrhcc Mobile Healthcare Van System (2)
- Tcrhcc Mobile Healthcare Van System (2)
- Edenbergh Que Tecson
- Madeline B Tecson
- Effie Dell Tewawina
- Brandon Owen Thomas
- Bernadine Thompson
- Ora Worker Thompson
- Scott Allen Thompson
- Valerie Thoroyan
All providers in Tuba City, AZ · Emergency Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.