Individual provider Active NPI

Timothy John Partridge, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Flagstaff, AZ
National Provider Identifier
1134495054
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
62878 Issued in AZ
Practice address
824 S San Francisco St
Flagstaff, AZ 86011-0001
Phone
(928) 523-2131
NPI assigned
Mar 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 042.0013502 VT
Sports Medicine (Family Medicine) Physician 207QS0010X 62878 AZ Primary

Addresses

Primary practice location

824 S San Francisco St
Flagstaff, AZ 86011-0001

Mailing address

824 S San Francisco St
Flagstaff, AZ 86011-0001
Phone (928) 523-2131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210410000069 AZ Practitioner - Sports MedicinePractitioner - Family Practice 1052607181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians

Practice addresses (Care Compare)

107 E Oak Ave
Suite 101And201
Flagstaff, AZ 86001-1818
Phone (928) 913-8800

Hospital & facility affiliations

  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007
  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.85
Promoting interoperability
99
Improvement activities
40
Cost
74.4

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62878AZMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince May 1, 2021 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine CurrentSince May 1, 2021 Accepting new patients
Az BD of Regents for on Behalf of Northern Az University Past Accepting new patients

Locations

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

107 E Oak Ave
Ste 201
Flagstaff, AZ 86001
Phone (928) 380-5689

107 E Oak Ave
Ste 101201
Flagstaff, AZ 86001
Phone (800) 656-7880

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

107 E Oak Ave
Ste 101
Flagstaff, AZ 86001
Phone (928) 774-1811

200 Lee St
Winslow, AZ 86047
Phone (928) 226-6400

Organizations & group practices 3

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 6

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": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1134495054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 S SAN FRANCISCO ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860110001",
            "telephone_number": "928-523-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 S SAN FRANCISCO ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860110001",
            "telephone_number": "928-523-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARTRIDGE",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-26",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VT",
            "license": "042.0013502",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "AZ",
            "license": "62878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.