Individual provider Active NPI

Alexander Lee Telis, M.D.

  • Orthopaedic Surgery Physician
  • Spokane, WA
National Provider Identifier
1114260510
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A154746 Issued in CA
Practice address
820 S McClellan St Ste 300
Spokane, WA 99204-2450
Phone
(509) 838-7100
Fax
(509) 227-7070
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A154746 CA Primary

Addresses

Primary practice location

820 S McClellan St Ste 300
Spokane, WA 99204-2450

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 838-7100

Other practice location 1

1520 San Pablo St Ste 2000
Los Angeles, CA 90033
Phone (323) 442-5860

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address atelis1150730@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191008003725 WA Practitioner - Orthopedic Surgery 9537394812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
George Washington University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

820 S McClellan St
Suite 300
Spokane, WA 99204-2450
Phone (509) 838-7100

Hospital & facility affiliations

  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
  • Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326
  • Newport Community Hospital Hospital, Newport, WA, CCN 501310
  • Providence St Joseph Hospital Hospital, Chewelah, WA, CCN 501309

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154746CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Orthopaedic Surgery CurrentSince Sep 15, 2019 Accepting new patients
Providence Health & Services - Wa Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

820 S McClellan St
Ste 300
Spokane, WA 99204
Phone (509) 464-7880

Interoperability endpoints

  • Direct secure messaging: atelis1150730@wm.providencedirect.org

Organizations & group practices 3

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": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1114260510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-838-7100",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S MCCLELLAN ST STE 300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042450",
            "telephone_number": "509-838-7100",
            "fax_number": "509-227-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 San Pablo St Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90033",
            "country_code": "US",
            "telephone_number": "323-442-5860",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELIS",
        "first_name": "ALEXANDER",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A154746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atelis1150730@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "820 S McClellan St Ste 300",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.