Active NPI
Timothy Nicholson
- Internal Medicine Physician
- Burnt Hills, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 217445
- Practice address
- 1184 State Route 50
Burnt Hills, NY 12019-1923 - Phone
- (518) 384-1281
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 217445 | NY | Primary |
| Pediatrics Physician | 208000000X | 217445 | NY |
Addresses
Primary practice location
1184 State Route 50
Burnt Hills, NY 12019-1923
Mailing address
711 Troy Schenectady Rd
Suite 201
Latham, NY 12110-2442
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02349659 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Boston University School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
711 Troy Schenectady Rd
Suite 203
Latham, NY 12110-2461
Phone (518) 782-3700
Hospital & facility affiliations
- Community Hospice, Inc, the
- Saratoga Hospital
- St Peter'S Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Physicians, PLLC | Internal Medicine | Current | Accepting new patients |
Locations
1184 State Route 50
Burnt Hills, NY 12019
Phone (518) 384-1281
711 Troy Schenectady Rd
Ste 203
Latham, NY 12110
Phone (518) 782-3742
711 Troy Schenectady Rd
#S201
Latham, NY 12110
711 Troy Schenectady Rd
Ste 201
Latham, NY 12110
711 Troy Schenectady Rd
Ste 210
Latham, NY 12110
6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Latham, NY
- NPI 1922048370
Hospital & facility affiliations 20
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Gansevoort, NY
- NPI 1033371166
Hospital
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1073569331
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1093078560
-
- General Acute Care Hospital
- Saratoga Springs, NY
- NPI 1700120482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360281600000",
"number": "1013091941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 TROY SCHENECTADY RD",
"address_2": "SUITE 201",
"city": "LATHAM",
"state": "NY",
"postal_code": "121102442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1184 STATE ROUTE 50",
"city": "BURNT HILLS",
"state": "NY",
"postal_code": "120191923",
"telephone_number": "518-384-1281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2013-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "217445",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "217445",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02349659",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burnt Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.