Individual provider Active NPI

Terry S Werner, M.D.

  • Otolaryngology Physician
  • Tuba City, AZ
National Provider Identifier
1578545208
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
44503 Issued in AZ
Practice address
167 North Main Street
Tuba City, AZ 86045-0600
Phone
(928) 283-2501
Fax
(928) 283-2677
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A67230 CA
Otolaryngology Physician 207Y00000X 35095568 OH
Otolaryngology Physician 207Y00000X 44503 AZ Primary

Addresses

Primary practice location

167 North Main Street
Tuba City, AZ 86045-0600

Mailing address

PO Box 600
Tuba City, AZ 86045-0600
Phone (928) 283-2501

Other identifiers 2

IdentifierTypeStateIssuer
00A672300MedicaidCA
3810018267MedicaidWV

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100505000656 TX Practitioner - Otolaryngology 8820998412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

167 Main St
Tcrhcc Mobile Medical Clinic
Tuba City, AZ 86045-0600
Phone (928) 283-2501

167 N Main St
Tuba City, AZ 86045-0600
Phone (928) 283-2094

P O Box
Suite 600
Tuba City, AZ 86045-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44503AZMDOtolaryngology Physician
A67230CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation Family Medicine CurrentSince Mar 15, 2010 Accepting new patients
Tuba City Regional Health Care Corporation Family Medicine CurrentSince Mar 15, 2010 Accepting new patients
Tuba City Regional Health Care Corporation Family Medicine Current Accepting new patients
Terry Werner, M.D., Inc. Otolaryngology PastSince Jul 29, 2005 Accepting new patients

Organizations & group practices 4

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 1

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1578545208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501",
            "fax_number": "928-283-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 NORTH MAIN STREET",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501",
            "fax_number": "928-283-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "TERRY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A67230",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35095568",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "44503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A672300",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810018267",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuba City, AZ

Sources for this page

Verify at the official NPI Registry.