Tim E Eckstein, DO

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

5101011920 Issued in MI

Practice address

2919 Wilder Rd
Suite 130
Bay City, MI 48706-9299

Phone

(989) 671-5720

Fax

(989) 671-5728

NPI assigned

Nov 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• Grand Valley Family Health Center

  • Family Medicine Physician
  • Grand Rapids, MI
  • NPI 1306062237
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1134101264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 N HARRISON ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024727",
            "telephone_number": "989-671-5720",
            "fax_number": "989-671-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 WILDER RD",
            "address_2": "SUITE 130",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069299",
            "telephone_number": "989-671-5720",
            "fax_number": "989-671-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKSTEIN",
        "first_name": "TIM",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101011920",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MI",
            "license": "5101011920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4589675",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0854102774",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "540Z90298",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  BLUE SHIELD",
            "identifier": "080D410020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1011090",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE PPO",
            "identifier": "080D410020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE NETWORK",
            "identifier": "1011090",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5689041",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Rose Eager
• East Side Family Physicians PC
• Fatima Ebrahim
• Ashle Ecker
• Erica Lynn Eckert
• Claire Elizabeth Economou
• Julianna Consuelo Eddy
• Nathan Daniel Edgington
• Marcie Ann Edwards, CCC-SLP
• Hassan El-Nachef, M.D.

• Occupational Medicine Physician in Bay City, MI
• Providers in Bay City, MI by specialty
• Occupational Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2014; 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.