Individual provider Active NPI

Nii Tetteh Tsuru Addy, D.O

  • Family Medicine Physician
  • Carlsbad, NM
National Provider Identifier
1790855732
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A1299-05 Issued in NM
Practice address
615 W Mermod St
Carlsbad, NM 88220-4912
Phone
(575) 887-8925
Fax
(575) 887-8935
NPI assigned
Nov 8, 2006
Last updated
Jul 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A1299-05 NM Primary

Addresses

Primary practice location

615 W Mermod St
Carlsbad, NM 88220-4912

Mailing address

615 W Mermod St
Carlsbad, NM 88220-4912
Phone (575) 887-8925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20050401000270 NM Practitioner - Family PracticePractitioner - Allergy/ImmunologyPractitioner - Osteopathic Manipulative MedicinePractitioner - Dermatology 3971554593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Allergy/Immunology, Dermatology, Osteopathic Manipulative Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

615 W Mermod St
Carlsbad, NM 88220-4911
Phone (575) 887-8925

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A1299-05NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Taddy Healthcare Services Family Medicine CurrentSince Apr 12, 2010 Accepting new patients
Allergy Clinic of America, LLC. CurrentSince Nov 27, 2012 Accepting new patients
Neurotechnology Devices, Inc Family Medicine PastSince May 22, 2012 Accepting new patients

Locations

615 W Mermod St
Carlsbad, NM 88220
Phone (575) 200-3465

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: taddynurse1@ths-nm.direct.office.nextgen.com

Organizations & group practices 3

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.

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1790855732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W MERMOD ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204912",
            "telephone_number": "575-887-8925",
            "fax_number": "575-887-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W MERMOD ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204912",
            "telephone_number": "575-887-8925",
            "fax_number": "575-887-8935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDY",
        "first_name": "NII TETTEH",
        "middle_name": "TSURU",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A1299-05",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

Verify at the official NPI Registry.