Individual provider Active NPI

Amy Mettman, MD

  • Otolaryngology Physician
  • Southlake, TX
National Provider Identifier
1174726772
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
N5868 Issued in TX
Practice address
660 W Southlake Blvd
Suite 100
Southlake, TX 76092-6069
Phone
(817) 416-9731
Fax
(817) 416-9751
NPI assigned
Jun 9, 2007
Last updated
Oct 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X N5868 TX Primary

Addresses

Primary practice location

660 W Southlake Blvd
Suite 100
Southlake, TX 76092-6069

Mailing address

660 W Southlake Blvd.
Suite 100
Southlake, TX 76092-6070
Phone (817) 416-9731

Other identifiers 1

IdentifierTypeStateIssuer
BP1-0026060OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110920000492 TX Practitioner - Otolaryngology 6507037702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Cincinnati College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ear, Nose and Throat Specialists, L.L.P.Group PAC ID 9133150691, 11 clinicians

Practice addresses (Care Compare)

1615 Hospital Pkwy
Suite 210
Bedford, TX 76022-5936
Phone (817) 540-3121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.85 of 100Reported as group
Quality
100
Promoting interoperability
88
Improvement activities
40
Cost
66.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ear, Nose & Throat Specialists, L.L.P. CurrentSince Mar 1, 2023 Accepting new patients
Michael D. Bryan, MD Otolaryngology PastSince Jul 5, 2011 Accepting new patients

Locations

1615 Hospital Pkwy
Ste 210
Bedford, TX 76022
Phone (817) 540-3121

4320 Windsor Centre Trl
Ste 200
Flower Mound, TX 75028
Phone (972) 691-0368

2813 W Southlake Blvd
Ste 150
Southlake, TX 76092
Phone (817) 835-9289

905 E Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 809-2400

Interoperability endpoints

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

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

Hospital & facility affiliations 3

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": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1174726772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 W SOUTHLAKE BLVD.",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926070",
            "telephone_number": "817-416-9731",
            "fax_number": "817-416-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 W SOUTHLAKE BLVD",
            "address_2": "SUITE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926069",
            "telephone_number": "817-416-9731",
            "fax_number": "817-416-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METTMAN",
        "first_name": "AMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-09",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "N5868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026060",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.