Clayton Lewis Theleman, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2019014000 Issued in MO

Practice address

2521 Glenn Hendren Dr Ste 108
Liberty, MO 64068

Phone

(816) 781-3515

Fax

(816) 781-3517

NPI assigned

Jun 27, 2014

Last updated

Jun 27, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Kansas School of Med (KC/Wich/Sal), 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New Liberty Hospital CorporationGroup PAC ID 9931166618, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Liberty Hospital Hospital, Liberty, MO, CCN 260177
• Excelsior Springs Hospital Hospital, Excelsior Springs, MO, CCN 261322

Merit-based Incentive Payment System (MIPS)

Final score

81.21 of 100Reported as group

Quality

69.99

Promoting interoperability

99

Improvement activities

40

Cost

68.22

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Interoperability endpoints

• Direct secure messaging: clayton.thelemanmd.p6@direct.nlhc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New Liberty Hospital Corporation

  dba The Kearney Clinic

  • Family Medicine Physician
  • Kearney, MO
  • NPI 1669734661
  Medicare reassignment Care Compare group NPD
• Excelsior Springs City Hospital

  dba Excelsior Springs Hospital

  • Critical Access Hospital
  • Excelsior Springs, MO
  • NPI 1609870310
  Medicare reassignment NPD
• Excelsior Springs City Hospital

  dba Excelsior Springs Hospital

  • Emergency Medicine Physician
  • Excelsior Springs, MO
  • NPI 1285733923
  Medicare reassignment
• New Liberty Hospital Coporation

  • Nephrology Physician
  • Liberty, MO
  • NPI 1053284190
  NPD
• New Liberty Hospital Corporation

  dba Liberty Hospital Physicians

  • Internal Medicine Physician
  • Liberty, MO
  • NPI 1205188570
  NPD
• New Liberty Hospital Coporation

  dba Liberty Hospital Primary Care Shoal Creek

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1821518630
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Excelsior Springs City Hospital

  dba Excelsior Springs Hospital

  • Critical Access Hospital
  • Excelsior Springs, MO
  • NPI 1609870310
  Care Compare affiliation
• New Liberty Hospital Corporation

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1548001464
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1013322080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219672",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641219672",
            "telephone_number": "816-407-4555",
            "fax_number": "816-407-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 GLENN HENDREN DR STE 108",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "64068",
            "telephone_number": "816-781-3515",
            "fax_number": "816-781-3517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 NE Glen Oak Ave",
            "address_2": "Suite 2670",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616033135",
            "country_code": "US",
            "telephone_number": "309-655-3971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "624 NE Glen Oak Ave",
            "address_2": "Suite 2670",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616033135",
            "country_code": "US",
            "telephone_number": "309-655-3971",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THELEMAN",
        "first_name": "CLAYTON",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "12506876",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2019014000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• TG&L Counseling LLC
• Samantha Thacker
• The Family Doctors Office PC
• The Liberty Clinic, Inc.
• The Urgency Room, LLC (The Urgency Room)
• Andria Mia Theoharidis, D.C.
• Dimitrios M Theoharidis, DC
• Theresa R Hubbard LLC
• Mary Juanita Thibodeaux, LCSW
• Tamra Thole, RD, LD

• Surgery Physician in Liberty, MO
• Providers in Liberty, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.