NPIMap

Individual provider Active NPI

Paul Manuel Tejera, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Canton, NY
National Provider Identifier
1295047736
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
279414 Issued in NY
Practice address
6119 US Highway 11
Canton, NY 13617-3991
Phone
(315) 261-5810
NPI assigned
Jul 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT196680 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 279414 NY Primary

Addresses

Primary practice location

6119 US Highway 11
Canton, NY 13617-3991

Mailing address

50 Leroy St
Potsdam, NY 13676-1786
Phone (315) 265-3300

Other practice location 1

50 LeRoy St
Potsdam, NY 13676-1786
Phone (315) 265-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150825003508 NY Practitioner - EndocrinologyPractitioner - Internal Medicine 4587970322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Canton-Potsdam HospitalGroup PAC ID 6204827280, 243 clinicians

Practice addresses (Care Compare)

12 Elm St
Potsdam, NY 13676-2166
Phone (315) 265-0745

Hospital & facility affiliations

  • Canton-Potsdam Hospital Hospital, Potsdam, NY, CCN 330197
  • SLHS Massena, Inc Hospital, Massena, NY, CCN 331322
  • Carthage Area Hospital, Inc Hospital, Ogdensburg, NY, CCN 331324
  • Gouverneur Hospital Hospital, Gouverneur, NY, CCN 331315
  • Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079

Merit-based Incentive Payment System (MIPS)

Final score
98.56 of 100Reported as apm
Quality
87.76
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT196680PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Canton-Potsdam Hospital CurrentSince Aug 3, 2015 Accepting new patients
Canton-Potsdam Hospital CurrentSince Aug 3, 2015 Accepting new patients
Canton Potsdam Hospital Past Accepting new patients

Locations

6119 US Highway 11
Ste 11
Canton, NY 13617

6119 US Highway 11
Canton, NY 13617
Phone (315) 261-5810

50 Leroy St
Potsdam, NY 13676
Phone (315) 261-6034

12 Elm St
Potsdam, NY 13676
Phone (315) 261-5420

201 Market St
Ste E
Potsdam, NY 13676
Phone (315) 274-9102

Interoperability endpoints

  • Direct secure messaging: ptejera333894@direct.rochesterregional.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295047736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6119 US HIGHWAY 11",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173991",
            "telephone_number": "315-261-5810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 LeRoy St",
            "address_purpose": "LOCATION",
            "city": "Potsdam",
            "state": "NY",
            "postal_code": "136761786",
            "country_code": "US",
            "telephone_number": "315-265-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEJERA",
        "first_name": "PAUL",
        "middle_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2022-07-21",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT196680",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NY",
            "license": "279414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, NY

Sources for this page

Verify at the official NPI Registry.