NPIMap

Individual provider Active NPI

Thomas Otto Mayer, MD

  • Neurology Physician
  • Sheridan, WY
National Provider Identifier
1104813930
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
6950A Issued in WY
Practice address
1050 Mydland Rd
Sheridan, WY 82801-2186
Phone
(307) 673-6300
Fax
(307) 673-6303
NPI assigned
Oct 6, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 6950A WY Primary

Addresses

Primary practice location

1050 Mydland Rd
Sheridan, WY 82801-2186

Mailing address

1050 Mydland Rd
Sheridan, WY 82801-2186
Phone (307) 673-6300

Other identifiers 5

IdentifierTypeStateIssuer
05696001OtherWYBCBS CLINIC NUMBER
119441100MedicaidWY
148019300OtherFEDERAL WORKERS COMPENSAT
313252OtherWYBCBS INDIVIDUAL
120469600MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050209000317 WY Practitioner - Neurology 9638120546 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Indiana University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Neurology PCGroup PAC ID 1557312469, 3 clinicians
Campbell County Hospital DistrictGroup PAC ID 2860392529, 128 clinicians

Practice addresses (Care Compare)

1050 Mydland Rd
Sheridan, WY 82801-2186
Phone (307) 673-6300

501 S Burma Ave
Gillette, WY 82716-3426
Phone (307) 688-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6950AWYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Peak Sleep Specialist LLC CurrentSince Feb 1, 2008 Accepting new patients
Sheridan Neurology PC Neurology CurrentSince Dec 2, 2004 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince May 2, 2022 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince May 2, 2022 Accepting new patients

Locations

650 S Ferguson Ave
Ste 1
Bozeman, MT 59718
Phone (406) 238-6670

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

1050 Mydland Rd
Sheridan, WY 82801
Phone (307) 673-6300

1416 W 5th St
Sheridan, WY 82801
Phone (307) 673-2884

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHACAA/Endpoint/CHACAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104813930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 MYDLAND RD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012186",
            "telephone_number": "307-673-6300",
            "fax_number": "307-673-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 MYDLAND RD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012186",
            "telephone_number": "307-673-6300",
            "fax_number": "307-673-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "THOMAS",
        "middle_name": "OTTO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WY",
            "license": "6950A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CLINIC NUMBER",
            "identifier": "05696001",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119441100",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMPENSAT",
            "identifier": "148019300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "313252",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120469600",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.