Timothy M. Wirtz, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

91019 Issued in PA

Practice address

1245 S Cedar Crest Blvd Ste 301
Allentown, PA 18103-6258

Phone

(610) 402-8896

Fax

(610) 402-9029

NPI assigned

Oct 4, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133
• Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Lehigh Valley Physician Group

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment Care Compare group
• Lehigh Valley Anesthesia Services, P. C.

  • Certified Registered Nurse Anesthetist
  • Allentown, PA
  • NPI 1730174731

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650
  NPD
• Lehigh Valley Physician Group

  • Family Medicine Physician
  • Hazleton, PA
  • NPI 1558125997
  NPD

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

• Lehigh Valley Hospital

  • General Acute Care Hospital
  • Allentown, PA
  • NPI 1164400131
  Care Compare affiliation
• Lehigh Valley Hospital

  • Clinic/Center
  • Allentown, PA
  • NPI 1194673467

  Hospital

  Care Compare affiliation
• Lehigh Valley Hospital

  • Clinic/Center
  • Allentown, PA
  • NPI 1528627155

  Hospital

  Care Compare affiliation
• Lehigh Valley Hospital

  • Psychiatric Hospital Unit
  • Bethlehem, PA
  • NPI 1609834001
  Care Compare affiliation
• Lehigh Valley Hospital

  • Children's Hospital
  • Allentown, PA
  • NPI 1952954307
  Care Compare affiliation
• Lehigh Valley Hospital - Schuylkill

  • Rural Acute Care Hospital
  • Pottsville, PA
  • NPI 1235138405
  Care Compare affiliation
• Schuylkill Medical Center - East Norweigan Street

  • General Acute Care Hospital
  • Pottsville, PA
  • NPI 1427050376
  Care Compare affiliation

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364169600000",
    "number": "1134471857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S CEDAR CREST BLVD STE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036258",
            "telephone_number": "610-402-8896",
            "fax_number": "610-402-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S CEDAR CREST BLVD STE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036258",
            "telephone_number": "610-402-8896",
            "fax_number": "610-402-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTZ",
        "first_name": "TIMOTHY",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2013-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN527078-L",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "91019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1613616",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027793790001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "1134471857",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL ADVANTAGE",
            "identifier": "50111779",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1134471857",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND. BLUE CROSS",
            "identifier": "3888598000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12447546",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY",
            "identifier": "2745893",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9551934",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert E Winkelspecht, OTR/L
• Thais Breim Winmill, FNP
• Sari Sage Winston, BCBA
• Odelee Marie Wint
• Rebecca Y Wint
• Richard J Wiscount, O.D.
• Mark Wiseman
• Makayla Carissa Wislotsky, PA-C
• Kristen Wismer
• Cayden Wisner

• Certified Registered Nurse Anesthetist in Allentown, PA
• Providers in Allentown, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.