Timothy Douglass

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN537606 Issued in PA

Practice address

700 High St
Williamsport, PA 17701-3100

Phone

(570) 321-2385

NPI assigned

May 26, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Williamsport Hospital, Williamsport, PA, CCN 390045

Merit-based Incentive Payment System (MIPS)

Final score

81.06 of 100Reported as group

Quality

62.07

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Susquehanna Physician Services

  • Pain Medicine Physician
  • Williamsport, PA
  • NPI 1639114689

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Susquehanna Physician Services

  • Radiology Clinic/Center
  • Mansfield, PA
  • NPI 1073361564
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Upmc Williamsport

  • Land Ambulance
  • Williamsport, PA
  • NPI 1093890360

  Hospital

  Care Compare affiliation
• Upmc Williamsport

  • Ambulatory Surgical Clinic/Center
  • Williamsport, PA
  • NPI 1225500770

  Hospital

  Care Compare affiliation
• Upmc Williamsport

  • Ambulatory Surgical Clinic/Center
  • Williamsport, PA
  • NPI 1285719559

  Hospital

  Care Compare affiliation
• Upmc Williamsport

  • General Acute Care Hospital
  • Williamsport, PA
  • NPI 1609801976
  Care Compare affiliation
• Upmc Williamsport

  • Psychiatric Hospital Unit
  • Williamsport, PA
  • NPI 1649746488
  Care Compare affiliation
• Upmc Williamsport

  • General Acute Care Hospital
  • Williamsport, PA
  • NPI 1740365097
  Care Compare affiliation
• Upmc Williamsport

  • Primary Care Clinic/Center
  • Williamsport, PA
  • NPI 1982788048

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1023337342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "address_2": "SUITE 1K",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-321-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN537606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "upmchospitals@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frank T Dominick III, C.P.
• Haley Ann Donahoe, PA-C
• Kaitlyn Donnelly
• Samer Refaat Doss
• Kelly Douglass, CRNP
• Richard Dowell
• Janice Dreher
• Joshua Drouin
• Tenzin Drukdak, CRNA
• Lindsey A Dry, LAT, ATC

• Certified Registered Nurse Anesthetist in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.