NPIMap

Individual provider Active NPI

Werner T. De Riese, M.D.

  • Urology Physician
  • Lubbock, TX
National Provider Identifier
1861478240
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
L4905 Issued in TX
Practice address
3601 4TH St Stop 7260
Lubbock, TX 79430-3300
Phone
(806) 743-1810
Fax
(806) 743-1335
NPI assigned
Dec 19, 2005
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L4905 TX
Urology Physician 208800000X L4905 TX Primary

Addresses

Primary practice location

3601 4TH St Stop 7260
Lubbock, TX 79430-3300

Mailing address

PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898

Other identifiers 11

IdentifierTypeStateIssuer
104999101MedicaidTX
82844ZOtherTXHMO BLUE
A022OtherNMTRIWEST
S8149MedicaidNM
104999102MedicaidTX
201021500OtherNMPRESBYTERIAN COMMERCIAL
87183GOtherTXBC/BS
111573102MedicaidTX
201021500MedicaidNM
100048660BMedicaidOK
111573100OtherTXFIRSTCARE COMMERCIAL

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address werner.deriese@ttuhsc.edu Texas Tech Physicians Associates at Lubbock
Direct Messaging Address werner.deriese@ttuhsc.edu B--UMCP Physician Specialists LLC
Direct Messaging Address werner.deriese@ttuhsc.edu UMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090708000785 TX Practitioner - UrologyPractitioner - General Surgery 2668524489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
UrologyAlso: General Surgery
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9406
Phone (806) 743-7337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L4905TXMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Oct 9, 1998 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Hendrick Provider Network CurrentSince Jul 1, 2014 Accepting new patients
Hendrick Provider Network Surgery CurrentSince Jul 1, 2014 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Surgery CurrentSince Oct 9, 1998 Accepting new patients
Texas Tech University Health Sciences Center Lubbock PastSince Oct 31, 2021 Accepting new patients
Texas Tech University Health Sciences Center Lubbock PastSince Oct 31, 2021 Accepting new patients

Locations

1904 Pine St
Ste 4A
Abilene, TX 79601
Phone (325) 437-4020

1924 Pine St
Ste 401
Abilene, TX 79601
Phone (325) 670-4242

3502 9th St
Ste 260
Lubbock, TX 79415
Phone (806) 743-1810

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

3601 4th St
Stop 7260
Lubbock, TX 79430
Phone (806) 743-1810

Interoperability endpoints

  • Direct secure messaging: werner.deriese@direct.myteamcare.com
  • Direct secure messaging: werner.deriese@ttuhsc.edu

Organizations & group practices 7

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 5

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1861478240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5865",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794085865",
            "telephone_number": "806-743-2898",
            "fax_number": "806-743-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 4TH ST STOP 7260",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794303300",
            "telephone_number": "806-743-1810",
            "fax_number": "806-743-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE RIESE",
        "first_name": "WERNER",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L4905",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "L4905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104999101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "82844Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "A022",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "S8149",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104999102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN COMMERCIAL",
            "identifier": "201021500",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "87183G",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111573102",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201021500",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100048660B",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE COMMERCIAL",
            "identifier": "111573100",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "werner.deriese@ttuhsc.edu",
            "affiliation": "Y",
            "affiliationName": "Texas Tech Physicians Associates at Lubbock",
            "address_1": "3601 4th St Stop 7260",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794303300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "werner.deriese@ttuhsc.edu",
            "affiliation": "Y",
            "affiliationName": "B--UMCP Physician Specialists LLC",
            "address_1": "3601 4th St Stop 7260",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794303300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "werner.deriese@ttuhsc.edu",
            "affiliation": "Y",
            "affiliationName": "UMC",
            "address_1": "3601 4th St Stop 7260",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794303300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.