Individual provider Active NPI

Roger E Teller, MD

  • Infectious Disease Physician
  • Covington, KY
National Provider Identifier
1992747372
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
33494 Issued in KY
Practice address
1500 James Simpson Jr Way
Covington, KY 41011-0801
Phone
(859) 655-1100
Fax
(859) 655-1102
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 01039670A IN
Infectious Disease Physician 207RI0200X 33494 KY Primary

Addresses

Primary practice location

1500 James Simpson Jr Way
Covington, KY 41011-0801

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 655-1100

Other identifiers 1

IdentifierTypeStateIssuer
64343940MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070628000044 KY Practitioner - Infectious DiseasePractitioner - Internal Medicine 5698874808 Reassigns benefits to 1 organization
I20240306004151 IN Practitioner - Infectious Disease 5698874808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, shared by 11 NPIs, 803 clinicians

Practice addresses (Care Compare)

1500 James Simpson Jr Way
Covington, KY 41011-0800
Phone (859) 655-4111

600 Wilson Creek Rd
Lawrenceburg, IN 47025-2751
Phone (812) 496-8771

Hospital & facility affiliations

  • St Elizabeth Home Care Home health agency, Florence, KY, CCN 187075
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue535
Removal of nail tissue11
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01039670AINMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc CurrentSince Sep 28, 2015 Accepting new patients
Summit Medical Group, Inc. CurrentSince Sep 28, 2015 Accepting new patients
Summit Medical Group, Inc Current Accepting new patients
Cardiovascular & Thoracic Surgeons, Inc. Past Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

1500 James Simpson Jr Way
Covington, KY 41011
Phone (859) 655-4353

334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065

20 Medical Village Dr
Ste 355
Edgewood, KY 41017
Phone (859) 341-6888

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6293/brand/1/csg/1/fhir/r4
  • Direct secure messaging: rteller25837@direct-prd.stelizabeth.com

Organizations & group practices 4

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 4

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1992747372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-655-1100",
            "fax_number": "859-655-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 JAMES SIMPSON JR WAY",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410110801",
            "telephone_number": "859-655-1100",
            "fax_number": "859-655-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLER",
        "first_name": "ROGER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01039670A",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KY",
            "license": "33494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64343940",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.