NPIMap

Individual provider Active NPI

Timothy Kavanaugh, MD

  • Orthopaedic Surgery Physician
  • Scottsdale, AZ
National Provider Identifier
1053304766
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
58251 Issued in AZ
Practice address
10200 N 92ND St Ste 225
Scottsdale, AZ 85258-4536
Phone
(480) 697-4824
Fax
(480) 697-4825
NPI assigned
Aug 26, 2005
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4942 AK
Orthopaedic Surgery Physician 207X00000X 58251 AZ Primary

Addresses

Primary practice location

10200 N 92ND St Ste 225
Scottsdale, AZ 85258-4536

Mailing address

10200 N 92ND St Ste 225
Scottsdale, AZ 85258-4536
Phone (480) 697-4824

Other identifiers 2

IdentifierTypeStateIssuer
997601MedicaidAZ
Z228811OtherAZMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190703000602 AZ Practitioner - Orthopedic Surgery 4486693546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Az Orthopedics LLCGroup PAC ID 7810365145, 12 clinicians

Practice addresses (Care Compare)

10200 N 92ND St
Suite 225
Scottsdale, AZ 85258-4536
Phone (480) 697-4824

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.64 of 100Reported as individual
Quality
65.32
Improvement activities
40
Cost
95.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement11
Knee replacement571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4942AKMDOrthopaedic Surgery Physician
200153NMMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Az Orthopedics LLC Orthopaedic Surgery CurrentSince Dec 1, 2022 Accepting new patients
Az Orthopedics LLC Orthopaedic Surgery CurrentSince Dec 1, 2022 Accepting new patients
Orthoalaska LLC PastSince Jan 21, 2024 Accepting new patients
John T. Duddy M.D. PC Orthopaedic Surgery PastSince Aug 23, 2004 Accepting new patients
Alaska Bone & Joint Institute PC Orthopaedic Surgery PastSince Feb 15, 2005 Accepting new patients

Locations

107 E Oak Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 774-1811

13660 N 94th Dr
Ste C4
Peoria, AZ 85381
Phone (480) 697-4824

10200 N 92nd St
Ste 225
Scottsdale, AZ 85258
Phone (480) 391-3885

10290 N 92nd St
Ste 101
Scottsdale, AZ 85258
Phone (480) 697-4824

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: timothy.kavanaugh.1@27410.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1053304766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 N 92ND ST STE 225",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584536",
            "telephone_number": "480-697-4824",
            "fax_number": "480-697-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 N 92ND ST STE 225",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584536",
            "telephone_number": "480-697-4824",
            "fax_number": "480-697-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AK",
            "license": "4942",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "58251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "997601",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z228811",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.