NPIMap

Individual provider Active NPI

Timothy John Mickus, MD

  • Diagnostic Neuroimaging (Radiology) Physician
  • Pittsburgh, PA
National Provider Identifier
1114153855
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Radiology) PhysicianTaxonomy code 2085D0003X
License
MD434566 Issued in PA
Practice address
320 E North Ave
Pittsburgh, PA 15212-4756
Phone
(412) 359-2459
Fax
(412) 359-8233
NPI assigned
Jun 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X MD434566 PA Primary

Addresses

Primary practice location

320 E North Ave
Pittsburgh, PA 15212-4756

Mailing address

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-2459

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmickus10493@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 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
I20100729000119 PA Practitioner - Diagnostic Radiology 5395878201 Reassigns benefits to 1 organization
I20210907002978 NY Practitioner - Diagnostic Radiology 5395878201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Vanderbilt University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chautauqua Medical Practice PCGroup PAC ID 5294920203, 103 clinicians
Allegheny Clinic RadiologyGroup PAC ID 8426364738, 153 clinicians

Practice addresses (Care Compare)

189 E Main St
Westfield, NY 14787-1104
Phone (716) 793-2221

320 E N Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-2459

Hospital & facility affiliations

  • Allegheny General Hospital Hospital, Pittsburgh, PA, CCN 390050
  • Forbes Hospital Hospital, Monroeville, PA, CCN 390267
  • Jefferson Hospital Hospital, Jefferson Hills, PA, CCN 390265
  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009
  • West Penn Hospital Hospital, Pittsburgh, PA, CCN 390090

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD434566PAMDDiagnostic Neuroimaging (Radiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chautauqua Medical Practice, P.C. CurrentSince Jul 1, 2021 Accepting new patients
Allegheny Clinic Radiology CurrentSince Sep 1, 2015 Accepting new patients

Locations

189 E Main St
Westfield, NY 14787
Phone (716) 326-4921

153 E 13th St
Ste 1300
Erie, PA 16503
Phone (814) 452-5081

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

320 E North Ave
#1
Pittsburgh, PA 15212
Phone (412) 359-3378

100 S Jackson Ave
Pittsburgh, PA 15202
Phone (412) 734-6030

320 E North Ave
Ste G70
Pittsburgh, PA 15212

Organizations & group practices 2

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 10

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": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1114153855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-2459",
            "fax_number": "412-359-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E NORTH AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124756",
            "telephone_number": "412-359-2459",
            "fax_number": "412-359-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKUS",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "PA",
            "license": "MD434566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmickus10493@direct.ahn.org",
            "affiliation": "N",
            "address_1": "320 E North Ave",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152124756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.