Timothy Ryan Tiberia

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0008402 Issued in MD

Practice address

3039 Glenn Valley LN Apt 306
Indian Trail, NC 28079-0060

Phone

(313) 910-3726

NPI assigned

Jan 27, 2021

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 DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• George Washington Univ Hospital Hospital, Washington, DC, CCN 090001

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment Care Compare group
• District Hospital Partners L P

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1487640207
  Medicare reassignment NPD
• District Hospital Partners LP

  • Family Nurse Practitioner
  • Washington, DC
  • NPI 1912517756
  NPD

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

• District Hospital Partners L P

  • General Acute Care Hospital
  • Washington, DC
  • NPI 1487640207
  Care Compare affiliation

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1114518818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3039 GLENN VALLEY LN APT 306",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280790060",
            "telephone_number": "313-910-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3039 GLENN VALLEY LN APT 306",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280790060",
            "telephone_number": "313-910-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBERIA",
        "first_name": "TIMOTHY",
        "middle_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-27",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Terrell, M.S. CCC-SLP
• The Art of Healing Physical Therapy & Rehabilitation Center LLC
• The Intentional Mind Counseling Services, P.L.L.C
• Samantha Kaye Thomas, M. ED.
• Carrie Virginia Thompson, M. ED., CCC-SLP
• Marleen Prychodko Traywick, FNP
• Wendy Jackson Truesdale, RPH
• George S. C. Tsai, M. D.
• Timothy Jerone Turner, DO
• Ubuntu Holistic Counseling & Consulting PLLC

• Physician Assistant in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.