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DR. TERI LYNNE BAUMGARTNER M.D.
NPI 1831194836
Obstetrics & Gynecology in Athens, TX

Active since June 16, 2005PECOS EnrolledAccepts Medicare Assignment
97.58/100
CMS Quality Rating
115 MEDICAL CIR STE 103, ATHENS, TX 75751(903) 677-8453(903) 677-8454 Get Directions Write a Review

NPPES record last updated: February 6, 2012. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. Teri Lynne Baumgartner M.d. NPPES

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

DR. TERI LYNNE BAUMGARTNER M.D. (NPI 1831194836) is an individual obstetrics & gynecology provider in Athens, Texas, licensed in Texas (K6959) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS, is affiliated with Ut Health East Texas Tyler Regional Hospital, and is a graduate of University Of Texas Medical School At Houston (1995).

NPPES Registry Identity

NPI1831194836
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameDR. TERI LYNNE BAUMGARTNERCredential: M.D.
Location Address115 MEDICAL CIR STE 103Athens, TX 75751-9004
Mailing Address115 Medical Cir Ste 103Athens, TX 75751-9004 · (903) 677-8453 · Fax (903) 677-8454
Phone(903) 677-8453
Fax(903) 677-8454
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 1995
Enumeration DateJune 16, 2005
Last NPPES UpdateFebruary 6, 2012
✔ NPI 1831194836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in TX · K6959
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
115 MEDICAL CIR STE 103, Athens, TX 75751
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Other Names 1

Other Name (5)Dr. Baumgartner Teri Lynne M.d.

Other Identifiers 5

Medicaid216528401TX
Medicare PIN8F2068
Other8S2731TX · Ind. Blue Cross Blue Shie
Medicare UPING86864TX
Medicaid178423301TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Teri Lynne Baumgartner 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 ID4789607417
PECOS Enrollment IDI20060109000972
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.

Medicare Billing Reassignment

Medicare enrollment records show Teri Baumgartner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Etmc Physician Group Inc.
34 mi
Cardiovascular Disease
1000 S BECKHAM AVE
Tyler, TX 75701
  • Reassigned Medicare billing, Texas enrollment
  • 636 clinicians in this Medicare group
NPI 1609382662 (903) 590-5611

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

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

Ut Health East Texas Tyler Regional Hospital

Acute Care Hospitals · Tyler, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number450083
Location1000 South Beckham AveTyler, TX 75701 · Smith County
Emergency services Birthing friendly

Ut Health East Texas Athens Hospital

Acute Care Hospitals · Athens, TX
2/5 CMS rating
OwnershipProprietary
CMS Certification Number450389
Location2000 South Palestine StAthens, TX 75751 · Henderson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75751 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

97.58/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.53
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 4

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

MRS. KIMBERLY MCCOY WHCNP
Nurse Practitioner (Women's Health)
115 MEDICAL CIR STE 103
ATHENS, TX 75751
Henderson County (903) 677-8453
BRITNE A CURRAN ANP
Nurse Practitioner (Women's Health)
115 MEDICAL CIR STE 103
ATHENS, TX 75751
Henderson County (903) 677-8453
TERI LYNNE BAUMGARTNER PLLC
Obstetrics & Gynecology (Obstetrics)
115 MEDICAL CIR STE 103
ATHENS, TX 75751
Henderson County (903) 677-8453
TERI LYNNE BAUMGARTNER M.D. PLLC
Obstetrics & Gynecology
115 MEDICAL CIR STE 103
ATHENS, TX 75751
Henderson County (903) 677-8453

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 Teri Baumgartner's NPI number?

The NPI number for Teri Baumgartner is 1831194836. It was assigned to this individual provider in the NPPES registry on June 16, 2005. The provider is also known as Dr. Baumgartner Teri Lynne M.D..

Where is Teri Baumgartner located?

Teri Baumgartner practices at 115 Medical Cir Ste 103, Athens, TX 75751. The listed phone number is (903) 677-8453.

What is Teri Baumgartner's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Teri Baumgartner enrolled in Medicare?

Yes. Teri Baumgartner 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.

Which organization bills Medicare for Teri Baumgartner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Teri Baumgartner reassigns Medicare benefits to Etmc Physician Group Inc. (Tyler, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Teri Baumgartner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Teri Baumgartner accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Teri Baumgartner 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 Teri Baumgartner affiliated with any hospitals?

According to CMS data, Teri Baumgartner is affiliated with Ut Health East Texas Tyler Regional Hospital and Ut Health East Texas Athens Hospital.

When was this NPI record last updated?

The NPPES record for Teri Baumgartner was last updated on February 6, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.