NPIMap

Organization Active NPI

Beverly Podiatry Inc.

  • Foot Surgery Podiatrist
  • Beverly, MA
National Provider Identifier
1073978987
Registry record updated May 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
1930 Issued in MA
Legal business name
BEVERLY PODIATRY INC.
Doing business as
Timothy Tobin D.P.M.
Practice address
900 Cummings Ctr
Suite 309V
Beverly, MA 01915-6198
Phone
(978) 922-0288
Fax
(978) 927-6265
NPI assigned
Dec 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2023

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

Authorized official

Name
Dr. Timothy J Tobin, DPMNPI 1760572234
Title
Owner
Phone
(978) 922-0288

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 1930 MA Primary
Durable Medical Equipment & Medical Supplies 332B00000X 1930 MA

Addresses

Primary practice location

900 Cummings Ctr
Suite 309V
Beverly, MA 01915-6198

Mailing address

900 Cummings Ctr
Suite 309V
Beverly, MA 01915-6198
Phone (978) 922-0288

Other names 1

  • Timothy Tobin D.P.M. Doing business as

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address Tobin.Timothy.BEVPOD@direct.partners.masshiway.net
Direct Messaging Address Calder.Rebecca.BEVPOD@direct.partners.masshiway.net
Direct Messaging Address McGinness.Lawrence.BEVPOD@direct.partners.masshiway.net

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160311000164 MA Part B Supplier - Clinic/Group Practice 4880990290 Receives reassigned benefits from 4 practitioners
Practice locations: Beverly, MA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: mcginness.lawrence.bevpod@direct.partners.masshiway.net
  • Direct secure messaging: tobin.timothy.bevpod@direct.partners.masshiway.net

Practitioners & affiliated clinicians

Practitioners 4

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": "1450396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1073978987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR",
            "address_2": "SUITE 309V",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156198",
            "telephone_number": "978-922-0288",
            "fax_number": "978-927-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CUMMINGS CTR",
            "address_2": "SUITE 309V",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156198",
            "telephone_number": "978-922-0288",
            "fax_number": "978-927-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY PODIATRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-18",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "TOBIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-922-0288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MA",
            "license": "1930",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "1930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tobin.Timothy.BEVPOD@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "900 Cummings Ctr",
            "address_2": "Suite 309V",
            "city": "Beverly",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019156198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Calder.Rebecca.BEVPOD@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "900 Cummings Ctr",
            "address_2": "Suite 309V",
            "city": "Beverly",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019156198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "McGinness.Lawrence.BEVPOD@direct.partners.masshiway.net",
            "affiliation": "N",
            "address_1": "900 Cummings Ctr",
            "address_2": "Suite 309V",
            "city": "Beverly",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019156198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Timothy Tobin D.P.M.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.