Jon C Ter Poorten, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

2000-00323 Issued in NC

Practice address

335 Penny LN
Concord, NC 28025-1221

Phone

(704) 784-5901

Fax

(704) 721-0413

NPI assigned

Dec 21, 2005

Last updated

Feb 12, 2009By 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 NC

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

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

University of Texas Medical School at Houston, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Group of the CarolinasGroup PAC ID 3678514759, 24 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.93 of 100Reported as group

Quality

69.47

Promoting interoperability

100

Improvement activities

40

Cost

83.64

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Dermatology Group of the Carolinas

  • Dermatology Physician
  • Concord, NC
  • NPI 1437110772
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1780660654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "702-721-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "704-721-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TER POORTEN",
        "first_name": "JON",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NC",
            "license": "2000-00323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126RR",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "70014929",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Teeter, LCMHC
• Linda Teeter
• Telehealth Carolina Inc. (ValorMed)
• Marjorie Telemaque, RN
• Tenway Express
• Maryanna C Ter Poorten, MD
• Deborah Kay Terzis, FNP
• Kelsie Nicole Teune, PA-C
• Nehal P. Thakkar, MD
• Siddarth Thakur, MD

• MOHS-Micrographic Surgery Physician in Concord, NC
• Providers in Concord, NC by specialty
• MOHS-Micrographic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.