Individual provider Active NPI

Maria Ann Tettis, PA-C

  • Physician Assistant
  • Smithfield, NC
National Provider Identifier
1912463340
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12159 Issued in NC
Practice address
100 Kellie Dr
Smithfield, NC 27577-9444
Phone
(919) 934-1094
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA060533 PA
Physician Assistant 363A00000X 0010-12159 NC Primary

Addresses

Primary practice location

100 Kellie Dr
Smithfield, NC 27577-9444

Mailing address

PO Box 5105
Belfast, ME 04915-5100
Phone (919) 220-5255

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220503002872 NC Practitioner - Physician Assistant 2365782687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

100 Kellie Dr
Smithfield, NC 27577-9444
Phone (919) 934-1094

2196 Hwy 42 W
Clayton, NC 27520-8343
Phone (919) 220-5255

3100 Duraleigh Rd
Suite 100
Raleigh, NC 27612-8105
Phone (919) 788-8797

741 A Tilghman Dr
Dunn, NC 28334-5507
Phone (910) 891-2432

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-12159NCMDPhysician Assistant
MA060533PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Mar 28, 2022 Accepting new patients
Emergeortho PA CurrentSince Mar 28, 2022 Accepting new patients

Locations

2196 Veterans Pkwy
Clayton, NC 27520
Phone (919) 763-1050

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

100 Kellie Dr
Smithfield, NC 27577
Phone (919) 934-1094

Interoperability endpoints

  • Direct secure messaging: mtettis857931@direct.unc.nchie.net
  • Direct secure messaging: maria.tettis.1@847.direct.athenahealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1912463340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5105",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155100",
            "telephone_number": "919-220-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KELLIE DR",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275779444",
            "telephone_number": "919-934-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETTIS",
        "first_name": "MARIA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060533",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

Verify at the official NPI Registry.