Raymund M Untalan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K5019 Issued in TX

Practice address

3555 Knickerbocker Rd
San Angelo, TX 76904-7610

Phone

(325) 224-5283

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Internal Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Enhabit Home Health Home health agency, Abilene, TX, CCN 679184
• Angels Care Home Health of San Angelo Home health agency, San Angelo, TX, CCN 679429
• Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score

82.63 of 100Reported as group

Quality

78.21

Promoting interoperability

96

Improvement activities

40

Cost

67.22

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: raymund.untalan.1@1902.direct.athenahealth.com
• Direct secure messaging: runtalan38905@shannonhealth.direct-ci.com

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.

• Shannon Clinic

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1770587149

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984

  Internal Medicine

  Medicare reassignment NPD
• Falls Clinic, P.C.

  • Surgery Physician
  • Crystal Falls, MI
  • NPI 1396831251
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• 1St Texas Home Health of San Angelo, Inc.

  • Home Health Agency
  • San Angelo, TX
  • NPI 1942205125
  Care Compare affiliation
• Eh of West Texas, LP

  • Home Health Agency
  • Abilene, TX
  • NPI 1942227459
  Care Compare affiliation
• Shannon Medical Center

  • General Acute Care Hospital
  • San Angelo, TX
  • NPI 1992707228
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1275590796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-949-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 KNICKERBOCKER RD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769047610",
            "telephone_number": "325-224-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNTALAN",
        "first_name": "RAYMUND",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K5019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD TX",
            "identifier": "86000G",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042392301",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "raymund.untalan.1@1902.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "3350 Executive Dr Ste 108",
            "city": "San Angelo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "769046878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rebecca S Turner, LCSW
• Rhonda S Turpin, LPC
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• Melody Kathleen Twombly
• United Supermarkets LLC
• Binita Upadhyaya
• Mary-Jo Urbano, CNM
• Kristi D. Urias, M.D.
• Robin Urso
• Ekemini Benedict Usoro, DO

• Internal Medicine Physician in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.