Active NPI
Timothy M Denman, MD
- Ophthalmology Physician
- Lake Oswego, OR
National Provider Identifier
1073582359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD09153
- Practice address
- 4035 Mercantile Dr
Suite 216
Lake Oswego, OR 97035-2546 - Phone
- (503) 636-2551
- Fax
- (503) 636-3055
- NPI assigned
- Mar 17, 2006
- Last updated
- May 29, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD09153 | OR | Primary |
Addresses
Primary practice location
4035 Mercantile Dr
Suite 216
Lake Oswego, OR 97035-2546
Mailing address
6420 SW Macadam Ave
Suite 216
Portland, OR 97239-3507
Phone (503) 244-8601
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180022040 | Other | OR | RAILROAD MEDICARE |
| 04877-7 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Eye Specialists, PC | Past | Accepting new patients | |
| Oregon Eye Specialists PC | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 2
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": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369785600000",
"number": "1073582359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6420 SW MACADAM AVE",
"address_2": "SUITE 216",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972393507",
"telephone_number": "503-244-8601",
"fax_number": "503-244-3013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4035 MERCANTILE DR",
"address_2": "SUITE 216",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970352546",
"telephone_number": "503-636-2551",
"fax_number": "503-636-3055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENMAN",
"first_name": "TIMOTHY",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2013-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OR",
"license": "MD09153",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180022040",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04877-7",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.