Individual provider Active NPI

Timothy James Walch, PA-C

  • Medical Physician Assistant
  • Rochester, NY
National Provider Identifier
1124530274
Registry record updated May 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
021654 Issued in NY
Practice address
1555 Long Pond Rd
Rochester, NY 14626-4122
Phone
(585) 723-7870
Fax
(585) 723-7871
NPI assigned
Oct 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 021654 NY Primary

Addresses

Primary practice location

1555 Long Pond Rd
Rochester, NY 14626-4122

Mailing address

1555 Long Pond Road
Department of Medicine
Rochester, NY 14626-4122
Phone (585) 723-7870

Other identifiers 1

IdentifierTypeStateIssuer
05022151MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twalch181483@direct.rochesterregional.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20180123001427 NY Practitioner - Physician Assistant 5799044699 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians
Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians

Practice addresses (Care Compare)

1415 Portland Ave
Suite 190
Rochester, NY 14621-3039
Phone (585) 336-5000

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

1561 Long Pond Rd
Suite 220
Rochester, NY 14626-4135
Phone (585) 383-8830

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Dec 3, 2018 Accepting new patients
Rochester General Hospital CurrentSince Dec 3, 2018 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Dec 3, 2018 Accepting new patients
The Unity Hospital of Rochester CurrentSince Nov 27, 2017 Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Interoperability endpoints

  • Direct secure messaging: twalch181483@direct.rochesterregional.org

Organizations & group practices 6

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": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1124530274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 LONG POND ROAD",
            "address_2": "DEPARTMENT OF MEDICINE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7870",
            "fax_number": "585-723-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 LONG POND RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264122",
            "telephone_number": "585-723-7870",
            "fax_number": "585-723-7871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCH",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-30",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "021654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05022151",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twalch181483@direct.rochesterregional.org",
            "affiliation": "N",
            "address_1": "1555 Long Pond Rd",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146264122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.