Individual provider Active NPI

Jerry Robert Realing, M.D.

  • Emergency Medicine Physician
  • Casper, WY
National Provider Identifier
1023235041
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
7785A Issued in WY
Practice address
1233 E 2ND St
Casper, WY 82601-2926
Phone
(307) 333-6910
Fax
(307) 333-6912
NPI assigned
Apr 19, 2007
Last updated
Mar 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5078 NE
Emergency Medicine Physician 207P00000X 7785A WY Primary

Addresses

Primary practice location

1233 E 2ND St
Casper, WY 82601-2926

Mailing address

PO Box 50770
Casper, WY 82605-0770
Phone (307) 333-6910

Other identifiers 4

IdentifierTypeStateIssuer
06273520MedicaidMS
124556200MedicaidWY
P00424701OtherRAILROAD MEDICARE
455571MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20070910000942 WY Practitioner - Emergency Medicine 8426141292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Physicians PCGroup PAC ID 4385771757, 13 clinicians

Practice addresses (Care Compare)

1233 E 2ND St
Casper, WY 82601-2926
Phone (307) 577-7201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.51 of 100Reported as group
Quality
90.63
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5078NEMDEmergency Medicine Physician
7785AWYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Physicians PC Emergency Medicine CurrentSince Feb 14, 2010 Accepting new patients
Emergency Medical Physicians PC Emergency Medicine CurrentSince Feb 14, 2010 Accepting new patients

Locations

1233 E 2nd St
Casper, WY 82601
Phone (307) 577-2171

Interoperability endpoints

  • Direct secure messaging: jerry.realing@direct.wyomingmedicalcenter.org

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1023235041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50770",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826050770",
            "telephone_number": "307-333-6910",
            "fax_number": "307-333-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 E 2ND ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012926",
            "telephone_number": "307-333-6910",
            "fax_number": "307-333-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REALING",
        "first_name": "JERRY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "5078",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "7785A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06273520",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124556200",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00424701",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "455571",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

Verify at the official NPI Registry.