Individual provider Active NPI

Timothy Farnum

  • Anesthesiology Physician
  • Lakewood, CO
National Provider Identifier
1093747578
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
42411 Issued in CO
Practice address
11600 W 2ND PL
Lakewood, CO 80228-1527
Phone
(720) 321-1048
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 42411 CO Primary

Addresses

Primary practice location

11600 W 2ND PL
Lakewood, CO 80228-1527

Mailing address

PO Box 150
Holly, CO 81047-0150
Phone (719) 537-0712

Other identifiers 1

IdentifierTypeStateIssuer
26005352MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, HI2 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

Enrollment IDStateProvider typePAC IDDetails
I20040518000763 CO Practitioner - Anesthesiology 9234129412 Reassigns benefits to 2 organizations
I20230726004119 HI Practitioner - Anesthesiology 9234129412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Chicago College of Osteopathy, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia Hawaii LLCGroup PAC ID 6002120599, 24 clinicians

Practice addresses (Care Compare)

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 885-4444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42411COMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia Hawaii, LLC Anesthesiology CurrentSince Jul 7, 2023 Accepting new patients
Boulder Valley Anesthesiology, PLLC Anesthesiology CurrentSince Mar 8, 2021 Accepting new patients

Locations

4747 Arapahoe Ave
Boulder, CO 80303
Phone (303) 415-7000

1100 Balsam Ave
Boulder, CO 80304
Phone (303) 415-7000

4450 Arapahoe Ave
Ste 100
Boulder, CO 80303
Phone (303) 415-2532

10170 Church Ranch Way
Westminster, CO 80021
Phone (303) 328-3400

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1093747578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "HOLLY",
            "state": "CO",
            "postal_code": "810470150",
            "telephone_number": "719-537-0712",
            "fax_number": "719-537-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281527",
            "telephone_number": "720-321-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNUM",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "42411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26005352",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.