DR. WILLIAM HARMON TETTELBACH (MD) – Infectious Disease Physician, NPI 1336143361
Infectious Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
58 INFECTIOUS DISEASE in UT
Provider Addresses for DR. WILLIAM HARMON TETTELBACH (MD)
308 E 4500 S STE 100
SALT LAKE CITY, UT 841074057
Phone: (385) 533-8898
Type: Location
176, South Bellevue Boulevard, Annesdale Park, Memphis, Shelby County, Tennessee, 38106, United States
SUITE 603
MEMPHIS, TN 381043424
Phone: (901) 516-8231
Fax: (901) 516-8249
Type: Mailing
3810 LARIAT RD
PARK CITY, UT 840984826
Phone: (901) 517-1889
Type: Mailing
190 E BANNOCK ST
BOISE, ID 837126241
Phone:
Type: Mailing
3277 E LOUISE DR STE 410
MERIDIAN, ID 836429360
Phone: (208) 489-5800
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 22 Open Payments records for all available years, with a total value of $108,099.
Total Amount is formed as General ($108,099) + Research ($0) + Ownership ($0) = $108,099.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: ConvaTec Inc. ($100,400).
Total Amount
$108,099
General + Research + Ownership
Payments
22
Total payment records
General Amount
$108,099
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ConvaTec Inc. | $100,400 |
| BioWound Solutions, Inc. | $5,000 |
| Bone Support Inc. | $750 |
| MIMEDX Group, Inc. | $531 |
| Kerecis Limited | $516 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-01-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051015000078 | I | Infectious Disease | UT | TBD |
| I20220105000901 | I | Preventive Medicine | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 145 | 44 | $0 |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 37 | 21 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 18 | 16 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 84107)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | UT | |
| Internal Medicine, Pulmonary Disease | UT | |
| Nurse Practitioner | UT |
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