Individual provider Active NPI

Timothy M Westgate, O. D.

  • Optometrist
  • Seaford, DE
National Provider Identifier
1093789752
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
130001190 Issued in DE
Practice address
1301 Bridgeville Hwy
Seaford, DE 19973-1616
Phone
(302) 629-9197
Fax
(302) 629-3335
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 130001190 DE Primary

Addresses

Primary practice location

1301 Bridgeville Hwy
Seaford, DE 19973-1616

Mailing address

885 S Governors Ave
Dover, DE 19904-4158
Phone (302) 734-5861

Other identifiers 6

IdentifierTypeStateIssuer
G00016OtherMEDICARE GROUP PIN
I3-0001190OtherDELICENSE
000A74H16OtherMEDICARE PTAN
11220847OtherCAQH
1245251313OtherMEDICARE GROUP NPI
000214822MedicaidDE

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

State licenses

LicenseStateTypeSpecialty
130001190DEMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Mar 7, 2016 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist CurrentSince Mar 7, 2016 Accepting new patients
Myeyedr Optometry of Delaware PA Optometrist Current Accepting new patients

Locations

885 S Governors Ave
Dover, DE 19904
Phone (302) 734-5861

1197 Airport Rd
Milford, DE 19963
Phone (302) 422-2020

1301 Bridgeville Hwy
Seaford, DE 19973
Phone (302) 262-8498

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

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.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1093789752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 S GOVERNORS AVE",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044158",
            "telephone_number": "302-734-5861",
            "fax_number": "302-734-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BRIDGEVILLE HWY",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199731616",
            "telephone_number": "302-629-9197",
            "fax_number": "302-629-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTGATE",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DE",
            "license": "130001190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "G00016",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "I3-0001190",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "000A74H16",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11220847",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NPI",
            "identifier": "1245251313",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000214822",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seaford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.