Ty Robert Witt, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

30147 Issued in AZ

Practice address

19610 N 68TH Ave
Glendale, AZ 85308-5515

Phone

(623) 215-6532

NPI assigned

Aug 22, 2005

Last updated

Jun 15, 2011By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Obstetrics/Gynecology

Education

Un of California, Irvine, College of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Okanogan Douglas County Hospital Dist 1Group PAC ID 7810882792, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Three Rivers Hospital Hospital, Brewster, WA, CCN 501324

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Chelan County Public Hospital District No 2

  dba Lake Chelan Community Hospital

  • Critical Access Hospital
  • Chelan, WA
  • NPI 1578568853
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1205942257
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395
  Medicare reassignment NPD
• JMM Ventures

  dba ty witt md

  • Specialist
  • Glendale, AZ
  • NPI 1437458098
  NPD (past) Authorized official
• JMM Ventures, LLC

  • Obstetrics & Gynecology Physician
  • Glendale, AZ
  • NPI 1982845012
  Authorized official Same address or phone
• Chelan County Public Hospital District No 2

  dba Express Care Clinic Lake Chelan Health

  • Rural Health Clinic/Center
  • Chelan, WA
  • NPI 1124438312
  NPD
• Okanogan Douglas County Hospital Dist1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1578649794
  NPD

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

• Okanogan Douglas County Hospital Dist 1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395
  Care Compare affiliation
• Okanogan Douglas District Hospital #1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1043363591
  Care Compare affiliation

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308096000000",
    "number": "1467444828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19610 N 68TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085515",
            "telephone_number": "623-215-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19610 N 68TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085515",
            "telephone_number": "623-215-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "TY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "30147",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00038457",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020730",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emad F Wissa, MD
• Lance Reed Wissman, D.P.M.
• Kyra Rene Witbeck, PA-C
• With Open Arms Homecare Az LLC
• Stephanie Witkemper
• Roxanne Ruth Witte, PH.D.
• Jeanne Patricia Witter, PHD, LPC, LISAC
• Gwen Annette Wodiuk, DNP, F.N.P.
• Carl William Woerner, DC
• Kamrie E Wolf, PA-C

• Obstetrics & Gynecology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Obstetrics & Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.