Individual provider Active NPI

Tiffany A Von Wald, M.D.

  • Reproductive Endocrinology Physician
  • Lone Tree, CO
National Provider Identifier
1093825408
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
49434 Issued in CO
Practice address
10290 Ridgegate Cir
Lone Tree, CO 80124-5331
Phone
(303) 788-8300
Fax
(303) 788-8310
NPI assigned
Aug 30, 2006
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X 8677 SD
Reproductive Endocrinology Physician 207VE0102X 49434 CO Primary

Addresses

Primary practice location

10290 Ridgegate Cir
Lone Tree, CO 80124-5331

Mailing address

10290 Ridgegate Cir
Lone Tree, CO 80124-5331
Phone (303) 788-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140210001216 MN Practitioner - Obstetrics/Gynecology 4486543444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49434COMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic CurrentSince Jan 7, 2014 Accepting new patients
Sanford Clinic Current Accepting new patients
Emergency Services, PA Past Accepting new patients
William B. Schoolcraft M.D. P.C Reproductive Endocrinology Past Accepting new patients

Locations

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

Interoperability endpoints

  • Direct secure messaging: tiffany.von.wald.1@17469.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1093825408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10290 RIDGEGATE CIR",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245331",
            "telephone_number": "303-788-8300",
            "fax_number": "303-788-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10290 RIDGEGATE CIR",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801245331",
            "telephone_number": "303-788-8300",
            "fax_number": "303-788-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON WALD",
        "first_name": "TIFFANY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "SD",
            "license": "8677",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CO",
            "license": "49434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lone Tree, CO

Sources for this page

Verify at the official NPI Registry.