Michael B Tentori, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

101770 Issued in MO

Practice address

6500 Hospital Dr
Hannibal, MO 63401-6890

Phone

(573) 629-3330

Fax

(573) 629-3334

NPI assigned

Mar 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
• Direct secure messaging: michaeltentori@hrmg.allscriptsdirect.net

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.

• Hannibal Regional Healthcare System, Inc

  dba Hannibal Regional Medical Group

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1134311392
  Medicare reassignment NPD
• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  NPD

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1932227907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "address_2": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-406-5888",
            "fax_number": "573-248-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016890",
            "telephone_number": "573-629-3330",
            "fax_number": "573-629-3334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 Elm Street",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MO",
            "postal_code": "634356877",
            "country_code": "US",
            "telephone_number": "573-288-5360",
            "fax_number": "573-288-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENTORI",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "MO",
            "license": "101770",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MO",
            "license": "DO101770",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "101770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932227907",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Wade Sutter
• Kristy Marie Taylor, MS, RDN, LD
• Matthew Aaron Tegg, LPC
• The Child Center, Inc
• Anna Laura Thomas, RD
• Duane M Thomas, D.D.S.
• Richard Shannon Thomas, JD, DO
• Terry Shannon Thomas, APRN-FNP

• Family Medicine Physician in Hannibal, MO
• Providers in Hannibal, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.