Individual provider Active NPI

Timothy E. Brelje, MD

  • Family Medicine Physician
  • Harlan, IA
National Provider Identifier
1144213836
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28345 Issued in IA
Practice address
1220 Chatburn Ave
Harlan, IA 51537-2009
Phone
(712) 755-5130
Fax
(712) 755-4470
NPI assigned
Aug 26, 2005
Last updated
Jan 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 28345 IA
Family Medicine Physician 207Q00000X 28345 IA Primary

Addresses

Primary practice location

1220 Chatburn Ave
Harlan, IA 51537-2009

Mailing address

1213 Garfield Ave
Harlan, IA 51537-2057
Phone (712) 755-5161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20040302001252 IA Practitioner - Family Practice 1153218367 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby County Chris a Myrtue Memorial Hospital Current Accepting new patients
Shelby County Chris a. Myrtue Memorial Hospital Family Medicine CurrentSince Aug 1, 1998 Accepting new patients

Locations

515 Pacific Ave
Audubon, IA 50025
Phone (712) 563-2611

1213 Garfield Ave
Harlan, IA 51537
Phone (712) 755-4316

1220 Chatburn Ave
Harlan, IA 51537
Phone (712) 755-5056

Interoperability endpoints

  • Direct secure messaging: tbrelje117887@uihcdirect.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Myrtue Medical Center HospiceHarlan, IA, CCN 161555 Hospice W-2 Managing Employee Jan 1, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199836800000",
    "number": "1144213836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 GARFIELD AVE",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515372057",
            "telephone_number": "712-755-5161",
            "fax_number": "712-755-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CHATBURN AVE",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515372009",
            "telephone_number": "712-755-5130",
            "fax_number": "712-755-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRELJE",
        "first_name": "TIMOTHY",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "28345",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "28345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, IA

Sources for this page

Verify at the official NPI Registry.