Individual provider Active NPI

Timothy D Missey, D.O.

  • Hospitalist Physician
  • Prescott, AZ
National Provider Identifier
1144548785
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
005426 Issued in AZ
Practice address
1003 Willow Creek Rd
Prescott, AZ 86301-1641
Phone
(928) 771-5487
Fax
(928) 771-5471
NPI assigned
May 6, 2010
Last updated
Mar 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 58.003262 OH
Internal Medicine Physician 207R00000X 005426 AZ
Hospitalist Physician 208M00000X 58.003262 OH
Hospitalist Physician 208M00000X 005426 AZ Primary

Addresses

Primary practice location

1003 Willow Creek Rd
Prescott, AZ 86301-1641

Mailing address

PO Box 11720
Prescott, AZ 86304-1720
Phone (928) 771-5487

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20210630002366 MT Practitioner - HospitalistPractitioner - Internal Medicine 2466585625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.75 of 100Reported as group
Quality
71.01
Promoting interoperability
100
Improvement activities
40
Cost
74.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58.003262OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Peter's Health CurrentSince Jul 1, 2021 Accepting new patients
St. Peter's Health CurrentSince Jul 1, 2021 Accepting new patients
St Peter's Health Current Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

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, 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": "1273104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1144548785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11720",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863041720",
            "telephone_number": "928-771-5487",
            "fax_number": "928-771-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011641",
            "telephone_number": "928-771-5487",
            "fax_number": "928-771-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSEY",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-06",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "58.003262",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "005426",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "58.003262",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "005426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.