Individual provider Active NPI

Robert Terry, MD

  • Family Medicine Physician
  • Towanda, PA
National Provider Identifier
1104313311
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD474620 Issued in PA
Practice address
132 Colonial Dr
Towanda, PA 18848-8107
Phone
(570) 265-6165
NPI assigned
Apr 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT216820 PA
Family Medicine Physician 207Q00000X 312900 NY
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD474620 PA Primary

Addresses

Primary practice location

132 Colonial Dr
Towanda, PA 18848-8107

Mailing address

132 Colonial Dr
Towanda, PA 18848-8107
Phone (570) 265-6165

Other practice location 1

1 Guthrie Sq
Sayre, PA 18840-1625
Phone (570) 887-2239

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rterry138378@direct-guthrie.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210930002970 PA Practitioner - Family Practice 6800143843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, 795 clinicians

Practice addresses (Care Compare)

132 Colonial Dr
Towanda, PA 18848-8107
Phone (570) 265-6165

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
312900NYMDFamily Medicine Physician
MD474620PAMDFamily Medicine Physician
MT216820PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C, Current Accepting new patients
Guthrie Medical Group, P.C. Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Guthrie Medical Group PC CurrentSince Sep 1, 2021 Accepting new patients
Guthrie Medical Group, P.C. Family Medicine Current Accepting new patients
Guthrie Medical Group, P.C. Family Medicine Current Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

132 Colonial Dr
Towanda, PA 18848
Phone (570) 265-6165

Interoperability endpoints

  • Direct secure messaging: rterry138378@direct-guthrie.org

Organizations & group practices 6

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

Hospital & facility affiliations 4

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1104313311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 COLONIAL DR",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188488107",
            "telephone_number": "570-265-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 COLONIAL DR",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188488107",
            "telephone_number": "570-265-6165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Guthrie Sq",
            "address_purpose": "LOCATION",
            "city": "Sayre",
            "state": "PA",
            "postal_code": "188401625",
            "country_code": "US",
            "telephone_number": "570-887-2239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRY",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT216820",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "312900",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD474620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rterry138378@direct-guthrie.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 Guthrie Sq",
            "city": "Sayre",
            "state": "PA",
            "country_code": "US",
            "postal_code": "188401625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Towanda, PA

Sources for this page

Verify at the official NPI Registry.