Thomas W. Herendeen, MD

Primary specialty

Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X

License

01041576A Issued in IN

Practice address

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604

Phone

(260) 426-8117

Fax

(260) 420-0817

NPI assigned

Aug 17, 2005

Last updated

Jun 20, 2016By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IN

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

Otolaryngology

Education

Indiana University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Nose and Throat Associates PCGroup PAC ID 3375504301, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Regional Medical Center Hospital, Fort Wayne, IN, CCN 150021
• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Adams Memorial Hospital Hospital, Decatur, IN, CCN 151330
• Parkview Wabash Hospital, Inc Hospital, Wabash, IN, CCN 151310

Merit-based Incentive Payment System (MIPS)

Final score

84.12 of 100Reported as individual

Quality

71.67

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: therendeen@entfortwayne.gwaydirect.com

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.

• Ear, Nose & Throat Associates, PC

  • Otolaryngology Physician
  • Fort Wayne, IN
  • NPI 1851377691
  Medicare reassignment Care Compare group NPD
• Allied Physicians Inc

  dba Fort Wayne Neurosurgery

  • Neurological Surgery Physician
  • Fort Wayne, IN
  • NPI 1366433369
  NPD (past)
• Allied Physicians Inc

  dba Physicians Hearing Clinic

  • Audiologist
  • Fort Wayne, IN
  • NPI 1992741698
  NPD (past)
• The Hearing Center LLC

  • Audiologist
  • Fort Wayne, IN
  • NPI 1891771655
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Adams County Memorial Hospital

  • Critical Access Hospital
  • Decatur, IN
  • NPI 1689696148
  Care Compare affiliation
• Iom Health System LP

  dba Lutheran Hospital of Indiana

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Parkview Hospital, Inc.

  dba Parkview Regional Medical Center

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1366407603
  Care Compare affiliation
• Parkview Wabash Hospital, Inc.

  dba Parkview Wabash Hospital

  • Critical Access Hospital
  • Wabash, IN
  • NPI 1245259878
  Care Compare affiliation

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1356333272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10021 DUPONT CIRCLE CT",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251604",
            "telephone_number": "260-426-8117",
            "fax_number": "260-420-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERENDEEN",
        "first_name": "THOMAS",
        "middle_name": "W.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "IN",
            "license": "01041576A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200163210",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2067043",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Herber
• Herbert P. Trier, M.D. (Associated Psychiatric Services)
• Madeline Herbst
• Gerardo Manuel Heredia Melero, M.D.
• Chrystal Heredia
• Jennifer M. Herl, MS
• Christine M Herman, PA-C
• Samantha Herman, RBT
• Tina J Hermes, NP
• Amy Lynn Hernandez

• Otolaryngology/Facial Plastic Surgery Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Otolaryngology/Facial Plastic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.