NPIMap

Individual provider Active NPI

Richard N Terry, DO

  • Family Medicine Physician
  • Oconomowoc, WI
National Provider Identifier
1124342738
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56872-21 Issued in WI
Practice address
1284 N Summit Ave
Oconomowoc, WI 53066-4459
Phone
(262) 560-3700
Fax
(262) 569-2206
NPI assigned
Mar 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 56872-21 WI Primary

Addresses

Primary practice location

1284 N Summit Ave
Oconomowoc, WI 53066-4459

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 560-3700

Other practice location 1

1038 E Geneva St
Delavan, WI 53115-1921
Phone (262) 728-4301

Other identifiers 2

IdentifierTypeStateIssuer
1124342738MedicaidWI
100030502MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rterry374875@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20130823000527 WI Practitioner - Family Practice 7911140942 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56872-21WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 17, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jun 17, 2023 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Mercy Health System Corporation CurrentSince Jul 1, 2015 Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine CurrentSince Aug 1, 2013 Accepting new patients
Mercy Health System Corporation CurrentSince Jul 1, 2015 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1038 E Geneva St
Delavan, WI 53115
Phone (262) 728-4301

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

1284 N Summit Ave
Summit, WI 53066
Phone (262) 560-3700

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: rterry374875@direct.myadvocateaurora.org

Organizations & group practices 8

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 7

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": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1124342738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-560-3700",
            "fax_number": "262-569-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 N SUMMIT AVE",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664459",
            "telephone_number": "262-560-3700",
            "fax_number": "262-569-2206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1038 E Geneva St",
            "address_purpose": "LOCATION",
            "city": "Delavan",
            "state": "WI",
            "postal_code": "531151921",
            "country_code": "US",
            "telephone_number": "262-728-4301",
            "fax_number": "262-728-8304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERRY",
        "first_name": "RICHARD",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "56872-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124342738",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100030502",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rterry374875@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1284 N Summit Ave",
            "city": "Oconomowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1284 N Summit Ave",
            "city": "Oconomowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530664459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.