Individual provider Active NPI

Terry Lee Mooty, CAA

  • Anesthesiologist Assistant
  • Madison, WI
National Provider Identifier
1508588948
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
627 Issued in WI
Practice address
600 Highland Ave
Madison, WI 53792-0001
Phone
(608) 263-8100
NPI assigned
Sep 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 627 WI Primary
Anesthesiologist Assistant 367H00000X
Anesthesiologist Assistant 367H00000X 11210 GA

Addresses

Primary practice location

600 Highland Ave
Madison, WI 53792-0001

Mailing address

7974 Uw Health CT
Middleton, WI 53562-5531
Phone (608) 263-8100

Other practice location 1

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4100

Other practice location 2

5354 Reynolds St Ste 424
Savannah, GA 31405-6011
Phone (912) 819-5999

Other practice location 3

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

Other practice location 4

210 E DeRenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Other practice location 5

247 S Main St
Reidsville, GA 30453-4605
Phone (912) 557-1207

Other practice location 6

11705 Mercy Blvd
Savannah, GA 31419-1711
Phone (912) 819-4100

Other practice location 7

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (470) 644-1274

Other practice location 8

101 Saint Josephs Candler Dr
Pooler, GA 31322-9584
Phone (912) 737-2231

Other practice location 9

7002 Hodgson Memorial Dr Ste 105
Savannah, GA 31406-1517
Phone (912) 355-7214

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmooty536976@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221020001649 GA Practitioner - Anesthesiology Assistant 4789050444 Reassigns benefits to 3 organizations
I20260529002560 WI Practitioner - Anesthesiology Assistant 4789050444 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians
Mak Anesthesia Holdings, LLCGroup PAC ID 4284917204, 370 clinicians

Practice addresses (Care Compare)

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 263-6400

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11210GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Dec 1, 2023 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Sep 13, 2022 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

2540 Windy Hill Rd SE
Marietta, GA 30067
Phone (470) 644-1274

101 Saint Josephs Candler Dr
Pooler, GA 31322
Phone (912) 450-1945

247 S Main St
Reidsville, GA 30453
Phone (478) 787-6255

3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 6

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 2

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": "1663027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1508588948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531",
            "telephone_number": "608-263-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11705 Mercy Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314191711",
            "country_code": "US",
            "telephone_number": "912-819-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5354 Reynolds St Ste 424",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056011",
            "country_code": "US",
            "telephone_number": "912-819-5999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5353 Reynolds St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056015",
            "country_code": "US",
            "telephone_number": "912-819-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "210 E DeRenne Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314056736",
            "country_code": "US",
            "telephone_number": "912-644-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "247 S Main St",
            "address_purpose": "LOCATION",
            "city": "Reidsville",
            "state": "GA",
            "postal_code": "304534605",
            "country_code": "US",
            "telephone_number": "912-557-1207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11705 Mercy Blvd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314191711",
            "country_code": "US",
            "telephone_number": "912-819-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2540 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678605",
            "country_code": "US",
            "telephone_number": "470-644-1274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Saint Josephs Candler Dr",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313229584",
            "country_code": "US",
            "telephone_number": "912-737-2231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7002 Hodgson Memorial Dr Ste 105",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314061517",
            "country_code": "US",
            "telephone_number": "912-355-7214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOOTY",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-13",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "627",
            "primary": true
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "11210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmooty536976@directwellstar.org",
            "affiliation": "N",
            "address_1": "2540 Windy Hill Rd SE",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300678605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.