NPIMap

Individual provider Active NPI

Timothy J Fitch, PA-C

  • Physician Assistant
  • Cottonwood, AZ
National Provider Identifier
1063417756
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6076 Issued in AZ
Practice address
450 S Willard St
Cottonwood, AZ 86326-6743
Phone
(928) 649-7960
Fax
(928) 634-1117
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6076 AZ Primary

Addresses

Primary practice location

450 S Willard St
Cottonwood, AZ 86326-6743

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 214-2922

Other identifiers 1

IdentifierTypeStateIssuer
158628MedicaidAZ

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
I20160126002474 AZ Practitioner - Physician Assistant 1951433853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
171MTMDRehabilitation Psychologist
6076AZMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Pathology Associates Current Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Nov 17, 2018 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Nov 17, 2018 Accepting new patients
Bridger Orthopedics and Sports Medicine, PC Past Accepting new patients

Locations

1298 W Finnie Flat Rd
Camp Verde, AZ 86322
Phone (928) 639-5509

450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

340 S Willard St
Cottonwood, AZ 86326
Phone (928) 634-5551

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

7810 N US Highway 89
Flagstaff, AZ 86004
Phone (928) 522-8375

2000 S Thompson St
Flagstaff, AZ 86001
Phone (928) 213-1051

1485 N Turquoise Dr
Ste 200
Flagstaff, AZ 86001
Phone (928) 774-7757

1485 N Turquoise Dr
Ste 220
Flagstaff, AZ 86001
Phone (928) 214-6626

3700 W State Route 89A
Sedona, AZ 86336
Phone (928) 204-3000

61 Bell Rock Plz
Sedona, AZ 86351
Phone (928) 204-4999

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12906/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1063417756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-214-2922",
            "fax_number": "928-214-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S WILLARD ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266743",
            "telephone_number": "928-649-7960",
            "fax_number": "928-634-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158628",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.