Teri S Formanek, M.D.

Key facts

NPI

1982644993

Entity type

Individual (NPI type 1)

Primary specialty

Orthopaedic Surgery Physician 207X00000X

License

26239 (IA)

Practice address

300 W Hutchings St
Winterset, IA 50273

Phone

(515) 462-2373

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 13

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.

• Adair County Memorial Hospital Emergency Medicine Physician · Greenfield, IA · NPI 1366531345
  Medicare reassignment Care Compare group NPD IA
• Adair County Memorial Hospital Critical Access Hospital · Greenfield, IA · NPI 1780667519
  Medicare reassignment Care Compare group NPD IA
• Madison County Memorial Hospital Primary Care Clinic/Center · Winterset, IA · NPI 1093929390
  Medicare reassignment Care Compare group NPD IA
• Madison County Memorial Hospital Critical Access Hospital · Winterset, IA · NPI 1831104611
  Medicare reassignment Care Compare group NPD IA
• Adair County Memorial Hospital Public Health or Welfare Agency · Greenfield, IA · NPI 1285614818
  Care Compare group NPD
• Madison County Memorial Hospital Medicare Defined Swing Bed Hospital Unit · Winterset, IA · NPI 1194880112
  Care Compare group NPD
• Madison County Memorial Hospital Rural Health Clinic/Center · Earlham, IA · NPI 1497810097
  Care Compare group NPD (past)
• Metro Orthopaedic Surgery, P.C. Orthopaedic Surgery Physician · Clive, IA · NPI 1558317305
  NPD (past) Authorized official ORTHOPAEDIC SURGERY
• Adair County Memorial Hospital Rural Health Clinic/Center · Greenfield, IA · NPI 1457398414
  Care Compare group
• Adair County Memorial Hospital Medicare Defined Swing Bed Hospital Unit · Greenfield, IA · NPI 1720191059
  Care Compare group
• Adair County Memorial Hospital Rural Health Clinic/Center · Stuart, IA · NPI 1932440146
  Care Compare group
• Madison County Memorial Hospital Rural Health Clinic/Center · Winterset, IA · NPI 1962567990
  Care Compare group
• Center for Occupational and Physical Medicine Occupational Medicine Clinic/Center · Clive, IA · NPI 1255698957
  NPD (past)

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adair County Memorial Hospital Critical Access Hospital · Greenfield, IA · NPI 1780667519
  Care Compare affiliation Hospital
• Madison County Memorial Hospital Critical Access Hospital · Winterset, IA · NPI 1831104611
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Hand Surgery
Also: Orthopedic Surgery

Education

University of Iowa, RJ & L Carver College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Madison County Memorial Hospital (42 clinicians)
Adair County Memorial Hospital (15 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madison County Health Care System Hospital · Winterset, IA · CCN 161326
• Adair County Memorial Hospital Hospital · Greenfield, IA · CCN 161310

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100 (apm)

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare participation

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/madico-8e3b1615
• Direct secure messaging: tformanek@madisonhealth.cernerdirect.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/823d67d6-97c5-40a2-b084-56d06cb82099/
• FHIR API: https://fhir-myrecord.cerner.com/r4/f904b187-16a4-4582-8ea3-887d87de0011/

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 22, 2021.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1982644993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HUTCHINGS ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502732109",
            "telephone_number": "515-462-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HUTCHINGS ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "50273",
            "telephone_number": "515-462-2373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12499 University Ave",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Clive",
            "state": "IA",
            "postal_code": "503258281",
            "country_code": "US",
            "telephone_number": "515-440-2676",
            "fax_number": "515-245-6422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMANEK",
        "first_name": "TERI",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IA",
            "license": "26239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2083659",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tformanek@madisonhealth.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Madison County Health Care System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "300 W Hutchings St",
            "city": "Winterset",
            "state": "IA",
            "country_code": "US",
            "postal_code": "50273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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All providers in Winterset, IA · Orthopaedic Surgery Physician in Iowa