NPIMap

Individual provider Active NPI

Timothy J Roddy, MD

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1083683023
Registry record updated Jul 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD14358 Issued in OR
Practice address
2101 NE 139TH St.
Suite 460
Vancouver, WA 98686
Phone
(360) 487-2727
Fax
(360) 487-2729
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD14358 OR Primary

Addresses

Primary practice location

2101 NE 139TH St.
Suite 460
Vancouver, WA 98686

Mailing address

2101 NE 139TH St
Suite 460
Vancouver, WA 98686
Phone (360) 487-2727

Other identifiers 2

IdentifierTypeStateIssuer
1027978MedicaidWA
136242MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070801000076 OR Practitioner - Internal MedicinePractitioner - Geriatric Medicine 7012008337 Reassigns benefits to 1 organization
I20070801000086 WA Practitioner - Internal MedicinePractitioner - Family Practice 7012008337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Wisconsin School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

2101 NE 139TH St
Suite 460
Vancouver, WA 98686-2325
Phone (360) 487-2727

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Vancouver, WA, CCN 507081
  • Healthy Living at Home - Vancouver LLC Home health agency, Vancouver, WA, CCN 507127
  • Amedisys Home Health Care Home health agency, Portland, OR, CCN 387003
  • Peacehealth Southwest Home Health Home health agency, Vancouver, WA, CCN 507064
  • Providence Hospice Hospice, Portland, OR, CCN 381500
  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Jan 15, 2007 Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Jan 15, 2007 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jan 15, 2007 Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

501 N Graham St
Ste 100
Portland, OR 97227
Phone 5032429850209

2222 NW Lovejoy St
Ste 505
Portland, OR 97210
Phone (503) 226-4091

300 N Graham St
Ste 200
Portland, OR 97227
Phone (503) 413-4134

19250 SW 65th Ave
Ste 110
Tualatin, OR 97062
Phone (503) 692-1205

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2101 NE 139th St
Ste 460
Vancouver, WA 98686
Phone (360) 487-2727

Interoperability endpoints

  • Direct secure messaging: troddy2870@direct.lhs.org

Organizations & group practices 3

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184371200000",
    "number": "1083683023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST",
            "address_2": "SUITE 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-487-2727",
            "fax_number": "360-487-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST.",
            "address_2": "SUITE 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98686",
            "telephone_number": "360-487-2727",
            "fax_number": "360-487-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODDY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD14358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027978",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136242",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.