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THEODORE S. HALEY M.D.
NPI 1871795203
Surgery in Gilbert, AZ

Active since June 05, 2007PECOS EnrolledAccepts Medicare Assignment
95.75/100
CMS Quality Rating
3367 S. MERCY RD, #210, GILBERT, AZ 85297(480) 969-4138(480) 969-0630 Get Directions Write a Review

NPPES record last updated: August 23, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 23, 2022, Mar 1, 2018, Aug 7, 2017 (3 updates tracked since 2017).

About Theodore S. Haley M.d. NPPES

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

THEODORE S. HALEY M.D. (NPI 1871795203) is an individual surgery provider in Gilbert, Arizona, licensed in Arizona (41538) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Arizona College Of Medicine (2004).

NPPES Registry Identity

NPI1871795203
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameTHEODORE S. HALEYCredential: M.D.
Location Address3367 S. MERCY RD, #210Gilbert, AZ 85297
Mailing Address2320 N 3rd StPhoenix, AZ 85004-1303 · (602) 258-9900 · Fax (602) 258-9904
Phone(480) 969-4138
Fax(480) 969-0630
Sole ProprietorNo
Medical School CMSUniversity Of Arizona College Of MedicineGraduated 2004
Enumeration DateJune 5, 2007
Last NPPES UpdateAugust 23, 20223 updates tracked since enumeration
NPPES CertifiedAugust 23, 2022
✔ NPI 1871795203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in AZ · 41538✔ Licensed in AZ · 76320
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
3367 S. MERCY RD, Gilbert, AZ 85297
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, UnitedHealthcare.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

Theodore S. Haley 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 ID4082768536
PECOS Enrollment IDI20090818000259
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 6

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.

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.
70 services70 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.
31 services27 patients
Repair of groin hernia using an endoscope 49650
This procedure involves the use of an endoscope, a thin tube with a camera, to repair a hernia in the groin area. The surgeon makes small incisions, inserts the endoscope, and uses special tools to fix the hernia. This minimally invasive technique often results in quicker recovery times.
26 services26 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
24 services24 patients
Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
22 services22 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.
17 services17 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85297 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$69.24 typical visit price
range $17.72 – $137.41
Typical copayment $17.31 (range $4.43 – $34.35)
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.

95.75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability95
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.

SUMEET KADAKIA M.D.
Surgery
3367 S. MERCY RD, #210
GILBERT, AZ 85297
Maricopa County (480) 969-4138
MATTHEW MARINI M.D.
Surgery
3367 S. MERCY RD, #210
GILBERT, AZ 85297
Maricopa County (480) 969-4138
DR. RICHARD D OH MD
Surgery
3367 S. MERCY RD, #210
GILBERT, AZ 85297
Maricopa County (480) 969-4138
DR. JENNIFER NICOLE REITZ MD
Surgery
3367 S. MERCY RD, #210
GILBERT, AZ 85297
Maricopa County (480) 969-4138

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 Theodore Haley's NPI number?

The NPI number for Theodore Haley is 1871795203. It was assigned to this individual provider in the NPPES registry on June 5, 2007.

Where is Theodore Haley located?

Theodore Haley practices at 3367 S. Mercy Rd #210, Gilbert, AZ 85297. The listed phone number is (480) 969-4138.

What is Theodore Haley's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Theodore Haley enrolled in Medicare?

Yes. Theodore Haley 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 Theodore Haley accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona and UnitedHealthcare list Theodore Haley 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.

When was this NPI record last updated?

The NPPES record for Theodore Haley was last updated on August 23, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.