Individual provider Active NPI

Tiffany H Selong, D.O.

  • Anesthesiology Physician
  • Boone, NC
National Provider Identifier
1245454388
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2006-00978 Issued in NC
Practice address
719A Greenway Road
Suite 100
Boone, NC 28607-2860
Phone
(828) 264-4691
Fax
(828) 265-4288
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2006-00978 NC Primary

Addresses

Primary practice location

719A Greenway Road
Suite 100
Boone, NC 28607-2860

Mailing address

PO Box 2270
Boone, NC 28607-2270
Phone (828) 264-4691

Other identifiers 2

IdentifierTypeStateIssuer
5912397MedicaidNC
2856173MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090611000427 NC Practitioner - Anesthesiology 4486716669 Reassigns benefits to 1 organization
I20210129001596 MT Practitioner - Anesthesiology 4486716669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters HealthGroup PAC ID 7911814926, 206 clinicians

Practice addresses (Care Compare)

2475 E Broadway St
Helena, MT 59601-4928
Phone (406) 447-2828

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.75 of 100Reported as group
Quality
71.01
Promoting interoperability
100
Improvement activities
40
Cost
74.84

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Peters Hospital CurrentSince Mar 1, 2021 Accepting new patients
St. Peter'S Health CurrentSince Mar 1, 2021 Accepting new patients
St Peter'S Health Current Accepting new patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Jul 1, 2019 Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

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 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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1245454388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2270",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286072270",
            "telephone_number": "828-264-4691",
            "fax_number": "828-265-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719A GREENWAY ROAD",
            "address_2": "SUITE 100",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286072860",
            "telephone_number": "828-264-4691",
            "fax_number": "828-265-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELONG",
        "first_name": "TIFFANY",
        "middle_name": "H",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2006-00978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5912397",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2856173",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boone, NC

Sources for this page

Verify at the official NPI Registry.