Timothy Andrew Ade, MD
Individual provider Active NPI Anesthesiology Physician · Urbana, IL
NPI 1043552672 · NPPES record last updated Oct 13, 2021
Key facts
- NPI
- 1043552672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 036157596 (IL)
- Practice address
- 611 W Park St
Urbana, IL 61801-2529 - Phone
- (217) 383-3311
- NPI assigned
- Mar 21, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Associated Anesthesiologists of Decatur
Practice addresses (Care Compare)
2300 N Edward St
Decatur, IL 62526-4163
Phone (217) 876-8121
Hospital & facility affiliations
- Decatur Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190821000888 | MN | Practitioner - Anesthesiology | 1658609284 | Reassigns benefits to 1 organization |
| I20220115000186 | IL | Practitioner - Anesthesiology | 1658609284 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036157596 | IL | MD | Anesthesiology Physician |
| 65758 | MN | MD | Anesthesiology Physician |
| 125062746 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Anesthesiologists of Decatur | Anesthesiology | Current |
Accepting new patients |
| Mayo Clinic | Current |
Accepting new patients |
Locations
2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
Interoperability endpoints
- tademd341077@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 65758 | MN | |
| Surgery Physician | 208600000X | 125062746 | IL | |
| Anesthesiology Physician | 207L00000X | 036157596 | IL | Yes |
Addresses
Primary practice location
611 W Park St
Urbana, IL 61801-2529
Mailing address
611 W Park St
Urbana, IL 61801-2529
Phone (217) 383-3311
Other providers in Urbana, IL
- Zakaria Abdulnabi
- Adel A Abood
- Hancel Achanzar
- Amy Adams
- Justine Ade
- Carrie Lynn Adkisson
- Brenda Adolph
- Naveed A Adoni I
- Saad Adoni
- Ladonna Aebischer
All providers in Urbana, IL · Anesthesiology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.