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THOMAS ORTEL M.D.
NPI 1003990995
Internal Medicine - Hematology in Durham, NC

Active since October 25, 2006PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: November 14, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Thomas Ortel M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS ORTEL M.D. (NPI 1003990995) is an individual hematology provider in Durham, North Carolina, licensed in North Carolina (37916) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Duke University Hospital, and is a graduate of Indiana University School Of Medicine (1985).

NPPES Registry Identity

NPI1003990995
Entity TypeIndividualMale
Primary Taxonomy207RH0000X
Provider Legal NameTHOMAS ORTELCredential: M.D.
Location AddressERWIN RDDurham, NC 27710-0001
Mailing Address4117 N Roxboro St, Duke University Medical Center - Dumc 3422Durham, NC 27704-2121 · (919) 684-8111
Phone(919) 620-4467
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 1985
Enumeration DateOctober 25, 2006
Last NPPES UpdateNovember 14, 2007
✔ NPI 1003990995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · HematologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0000X
License✔ Licensed in NC · 37916
Definition
An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.
ERWIN RD, Durham, NC 27710
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Other Identifiers 3

Medicare ID-Type Unspecified8964379NC
Medicare ID-Type Unspecified2159722NC
Medicare ID-Type UnspecifiedE84878

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thomas Ortel M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103953443
PECOS Enrollment IDI20100419000717
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Coagulation function screening test with interpretation and report 85390
A coagulation function screening test is a type of blood test that checks how well your blood clots. It's important because clotting helps prevent excessive bleeding. The test results are interpreted and a report is provided to help guide your doctor's treatment plan.
134 services75 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
88 services79 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
19 services18 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Duke University Hospital

Acute Care Hospitals · Durham, NC
5/5 CMS rating
OwnershipProprietary
CMS Certification Number340030
Location2100 Erwin RdDurham, NC 27705 · Durham County
Emergency services Birthing friendly

Duke Regional Hospital

Acute Care Hospitals · Durham, NC
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number340155
Location3643 N Roxboro StreetDurham, NC 27704 · Durham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27710 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$165.09 typical visit price
range $54.12 – $165.09
Typical copayment $41.27 (range $13.53 – $41.27)
Most-billed visit code 99205
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINE A EATON CRNA
Nurse Anesthetist, Certified Registered
ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-3595
JOSEPH MOORE M.D.
Internal Medicine (Hematology & Oncology)
ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-4811
MRS. ELISE M. WEBB CRNA
Nurse Anesthetist, Certified Registered
ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-8111
KEVIN D. DEDMOND CRNA
Nurse Anesthetist, Certified Registered
ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-8111
MARIA A SELIM M.D.
Pathology (Anatomic Pathology)
ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-8111
SUSAN HILL LCSW
Counselor (Mental Health)
ERWIN RD
DURHAM, NC 27710
Durham County (919) 995-7943
XIUFEN HUANG CRNA
Nurse Anesthetist, Certified Registered
ERWIN RD
DURHAM, NC 27710
Durham County (919) 384-3595
LEAH M. FITZGERALD CRNA
Nurse Anesthetist, Certified Registered
ERWIN RD
DURHAM, NC 27710
Durham County (919) 684-3595

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thomas Ortel's NPI number?

The NPI number for Thomas Ortel is 1003990995. It was assigned to this individual provider in the NPPES registry on October 25, 2006.

Where is Thomas Ortel located?

Thomas Ortel practices at Erwin Rd, Durham, NC 27710. The listed phone number is (919) 620-4467.

What is Thomas Ortel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Is Thomas Ortel enrolled in Medicare?

Yes. Thomas Ortel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Thomas Ortel accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list Thomas Ortel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Thomas Ortel affiliated with any hospitals?

According to CMS data, Thomas Ortel is affiliated with Duke University Hospital and Duke Regional Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Ortel was last updated on November 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.