Individual provider Active NPI

Timothy Sears, MD

  • Surgery Physician
  • Hancock, MI
National Provider Identifier
1063450526
Registry record updated Nov 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MI43067933 Issued in MI
Practice address
500 Campus Dr
Hancock, MI 49930-1569
Phone
(906) 483-1040
Fax
(906) 483-1043
NPI assigned
Jun 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MI43067933 MI Primary

Addresses

Primary practice location

500 Campus Dr
Hancock, MI 49930-1569

Mailing address

500 Campus Dr
Hancock, MI 49930-1569
Phone (906) 483-1040

Other identifiers 4

IdentifierTypeStateIssuer
0C16002OtherMIMEDICARE GROUP
TS067933OtherMIBLUECROSS STATE ID
104308999MedicaidMI
0829560001OtherMIMEDICARE DME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100304000071 MI Practitioner - General Surgery 3971641333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portage Physician Practices IncGroup PAC ID 6103053509, 56 clinicians

Practice addresses (Care Compare)

500 Campus Dr
Hancock, MI 49930-1452

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy93
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux37
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MI43067933MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portage Physician Practices Inc CurrentSince Dec 1, 2013 Accepting new patients
Portage Physician Practices Inc CurrentSince Dec 1, 2013 Accepting new patients
PH Copper Country Apothecaries LLC PastSince Jan 1, 2007 Accepting new patients
Portage Health Inc. Past Accepting new patients

Locations

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

500 Campus Dr
Ste 1
Hancock, MI 49930
Phone (906) 483-1040

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

600 Macinnes Dr
Houghton, MI 49931
Phone (906) 483-1818

Interoperability endpoints

  • Direct secure messaging: timothy.sears.1@8233.direct.athenahealth.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1063450526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1040",
            "fax_number": "906-483-1043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301569",
            "telephone_number": "906-483-1040",
            "fax_number": "906-483-1043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEARS",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "MI43067933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "0C16002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS STATE ID",
            "identifier": "TS067933",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104308999",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0829560001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

Verify at the official NPI Registry.