Timothy David Brock, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

BP1-0032535 Issued in TX

Practice address

301 University Blvd
University of Texas Medical Branch
Galveston, TX 77555-1173

Phone

(409) 772-7118

Fax

(409) 772-9068

NPI assigned

May 7, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

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 2

Specialty

Emergency Medicine

Education

Oregon Health Sciences University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Public Hospital District No. 2, Klickitat County, WashingtonGroup PAC ID 4981592144, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071
• Skyline Hospital Hospital, White Salmon, WA, CCN 501315

Merit-based Incentive Payment System (MIPS)

Final score

98.83 of 100Reported as group

Quality

83.85

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/

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.

• Public Hospital District No 2, Klickitat County Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1952483653

  WA

  Medicare reassignment Care Compare group NPD
• Public Hospital District No. 2, Klickitat County, Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687

  WA

  Medicare reassignment Care Compare group NPD
• Western Healthcare Services Texas

  • Emergency Medicine Physician
  • Gold Beach, OR
  • NPI 1336878024

  Emergency Medicine, OR

  Medicare reassignment NPD
• Public Hospital District No 2, Klickitat County, Washington

  • Rural Health Clinic/Center
  • White Salmon, WA
  • NPI 1467961250
  Care Compare group NPD
• Emergency Medical Associates of McMinnville

  • Emergency Medicine Physician
  • McMinnville, OR
  • NPI 1629022876

  OR

  Medicare reassignment
• Public Hospital District No 2, Klickitat County, Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1689779324
  Care Compare group

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

• Public Hospital District No. 2, Klickitat County, Washington

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687

  Hospital

  Care Compare affiliation
• Willamette Valley Medical Center LLC

  • General Acute Care Hospital
  • McMinnville, OR
  • NPI 1346269982

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1083880249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "UNIVERSITY OF TEXAS MEDICAL BRANCH",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551173",
            "telephone_number": "409-772-7118",
            "fax_number": "409-772-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "UNIVERSITY OF TEXAS MEDICAL BRANCH",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775551173",
            "telephone_number": "409-772-7118",
            "fax_number": "409-772-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "TIMOTHY",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "BP1-0032535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Galveston, TX
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.