Individual provider Active NPI

Timothy Lawler, D.O.

  • General Practice Physician
  • Milwaukee, WI
National Provider Identifier
1053552455
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
66559-21 Issued in WI
Practice address
11414 W Park PL
Suite 100
Milwaukee, WI 53224-3500
Phone
(414) 359-0800
NPI assigned
Mar 13, 2009
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 20A12811 CA
General Practice Physician 208D00000X 66559-21 WI Primary

Addresses

Primary practice location

11414 W Park PL
Suite 100
Milwaukee, WI 53224-3500

Mailing address

11414 W Park PL
Suite 100
Milwaukee, WI 53224-3500
Phone (414) 359-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190806001304 CA Practitioner - Preventive Medicine 8123305216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Practice addresses (Care Compare)

2929 Health Ctr Dr
San Diego, CA 92123-2762
Phone (858) 499-2600

300 Fir St
San Diego, CA 92101-2327
Phone (848) 499-2600

3075 Health Ctr Dr
Suite 401
San Diego, CA 92123-2773
Phone (858) 499-2600

344 F St
Suite 300
Chula Vista, CA 91910-2647
Phone (619) 585-4080

480 H St
Chula Vista, CA 91910-4328
Phone (858) 499-2600

8008 Frost St
Suite 106
San Diego, CA 92123-4229
Phone (858) 499-2600

8010 Frost St
FL 2
San Diego, CA 92123-4284
Phone (858) 499-2600

8975 Balboa Ave
San Diego, CA 92123-1507
Phone (858) 499-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A12811CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jul 9, 2019 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jul 9, 2019 Accepting new patients
Sharp Rees-Stealy Medical Center Past Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
Ste A
San Diego, CA 92111
Phone (858) 262-6109

Interoperability endpoints

  • Direct secure messaging: tlawler24869@sharphealthcare.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1053552455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11414 W PARK PL",
            "address_2": "SUITE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243500",
            "telephone_number": "414-359-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11414 W PARK PL",
            "address_2": "SUITE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243500",
            "telephone_number": "414-359-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLER",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A12811",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "66559-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.