Mary Alyssa Terra, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

59590 Issued in MN

Practice address

101 Martin Luther King Dr
Mankato, MN 56001-6460

Phone

(507) 837-4164

NPI assigned

May 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Osteopathic Manipulative Medicine

Education

Pacific NW Un of HS, Col of Osteopathic Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairbanks Memorial Hospital Hospital, Fairbanks, AK, CCN 020012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.terra.1@15989.direct.athenahealth.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.

• Tanana Chiefs Conference

  • Multi-Specialty Clinic/Center
  • Fairbanks, AK
  • NPI 1821201278

  TX

  Medicare reassignment Care Compare group NPD
• Tanana Chiefs Conference

  • Ambulatory Surgical Clinic/Center
  • Fairbanks, AK
  • NPI 1871332387
  NPD

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

• Fairbanks Memorial Hospital, LLC

  • General Acute Care Hospital
  • Fairbanks, AK
  • NPI 1720537178
  Care Compare affiliation

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1437560299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MARTIN LUTHER KING DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016460",
            "telephone_number": "507-837-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MARTIN LUTHER KING DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016460",
            "telephone_number": "507-837-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRA",
        "first_name": "MARY",
        "middle_name": "ALYSSA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "59590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark P Taylor, MD
• Erika Teachout, LPCC
• Faith M Teah
• Gudrun Teigen, MSW, LICSW, LADC
• Jeanne Marie Ternes, PHARMD
• Jacob A Tester
• Lylah Thao
• The Blue Couch
• The Lutheran Home Cedar Haven
• The Lutheran Home: Cedar Haven

• Family Medicine Physician in Mankato, MN
• Providers in Mankato, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.