Organization Active NPI

Timothy R Rasmusson MD, PC

  • Surgery Physician
  • Kenmore, NY
National Provider Identifier
1073204681
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
TIMOTHY R RASMUSSON MD, PC
Practice address
2914 Elmwood Ave
Kenmore, NY 14217-1332
Phone
(716) 204-9729
Fax
(716) 204-9406
NPI assigned
May 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Dr. Timothy R. Rasmusson, MDNPI 1538169875
Title
Owner
Phone
(716) 204-9729

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2914 Elmwood Ave
Kenmore, NY 14217-1332

Mailing address

2914 Elmwood Ave
Kenmore, NY 14217-1332
Phone (716) 204-9729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230710002056 NY Part B Supplier - Clinic/Group Practice 4789043605 Receives reassigned benefits from 1 practitioner
Practice locations: Kenmore, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1073204681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171332",
            "telephone_number": "716-204-9729",
            "fax_number": "716-204-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171332",
            "telephone_number": "716-204-9729",
            "fax_number": "716-204-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY R RASMUSSON MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "RASMUSSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-204-9729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.