Individual provider Active NPI

Thomas M Penoyar, M.D.

  • Surgery Physician
  • Ellensburg, WA
National Provider Identifier
1205140597
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60523679 Issued in WA
Practice address
611 S Chestnut St
Ellensburg, WA 98926-4815
Phone
(509) 962-7397
NPI assigned
Jul 29, 2010
Last updated
May 3, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60523679 WA Primary

Addresses

Primary practice location

611 S Chestnut St
Ellensburg, WA 98926-4815

Mailing address

611 S Chestnut St
Ellensburg, WA 98926-4815

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
I20150824000705 WA Practitioner - General Surgery 1759696529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Washington School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

611 S Chestnut St
Suite a
Ellensburg, WA 98926-4815
Phone (509) 962-7390

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.91 of 100Reported as group
Quality
66.6
Promoting interoperability
100
Improvement activities
40
Cost
69.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy42
Hernia repair - groin (open)12
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux17
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas County Public Hospital Dist 1 CurrentSince Aug 11, 2015 Accepting new patients
Kittitas County Public Hosp Dist 1 CurrentSince Aug 11, 2015 Accepting new patients
Kittitas County Public Hospital Dist 1 Current Accepting new patients
Kittitas County Public Hospital Dist 1 Past Accepting new patients

Locations

201 Alpha Way
Cle Elum, WA 98922
Phone (509) 674-5331

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

611 S Chestnut St
Ste A
Ellensburg, WA 98926
Phone (509) 933-7575

Interoperability endpoints

  • Direct secure messaging: tpenoyar@kittitasvalleyhealthcare.cernerdirect.com

Organizations & group practices 4

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 1

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": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1205140597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S CHESTNUT ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989264815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S CHESTNUT ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989264815",
            "telephone_number": "509-962-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENOYAR",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60523679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.