Individual provider Active NPI

John G Tellers, M.D.

  • Specialist
  • Wheeling, WV
National Provider Identifier
1881634889
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10496 Issued in WV
Practice address
40 Medical Park
Suite 500
Wheeling, WV 26003-6392
Phone
(304) 242-9260
Fax
(304) 242-9484
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10496 WV Primary

Addresses

Primary practice location

40 Medical Park
Suite 500
Wheeling, WV 26003-6392

Mailing address

40 Medical Park
Suite 500
Wheeling, WV 26003-6392
Phone (304) 242-9260

Other identifiers 2

IdentifierTypeStateIssuer
0091065000MedicaidWV
0508838MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20120328001035 WV Practitioner - Neurology 7416117494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
West Virginia University School of Medicine, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

1 Medical Park
Wheeling, WV 26003-6379
Phone (304) 243-3000

Hospital & facility affiliations

  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10496WVMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Inc CurrentSince Oct 1, 2012 Accepting new patients
Wheeling Hospital, Inc. Past Accepting new patients

Locations

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

2000 Eoff St
Wheeling, WV 26003
Phone (304) 234-0123

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

40 Medical Park
Ste 500
Wheeling, WV 26003
Phone (304) 242-9260

Interoperability endpoints

  • Direct secure messaging: jtellers319619@direct.wvuhsdirect.com

Organizations & group practices 2

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1881634889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MEDICAL PARK",
            "address_2": "SUITE 500",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036392",
            "telephone_number": "304-242-9260",
            "fax_number": "304-242-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MEDICAL PARK",
            "address_2": "SUITE 500",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260036392",
            "telephone_number": "304-242-9260",
            "fax_number": "304-242-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLERS",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "10496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091065000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0508838",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.