Dwight Peter Lim Tiu, M.D.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

ME75674 Issued in FL

Practice address

1 Florida Park Dr N
Palm Coast, FL 32137-3852

Phone

(904) 728-6934

Fax

(386) 251-0943

NPI assigned

Jun 13, 2005

Last updated

Dec 20, 2024By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Acute Care Pediatrics,PA

  • Rural Health Clinic/Center
  • Palatka, FL
  • NPI 1003866732

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1154326585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 FLOYD CT",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378301",
            "telephone_number": "386-328-5437",
            "fax_number": "386-447-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FLORIDA PARK DR N",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373852",
            "telephone_number": "904-728-6934",
            "fax_number": "386-251-0943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Reid St",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321773237",
            "country_code": "US",
            "telephone_number": "386-328-5437",
            "fax_number": "386-447-7348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "397 Palm Coast Pkwy SW Unit 303",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321374776",
            "country_code": "US",
            "telephone_number": "386-447-7337",
            "fax_number": "386-447-7348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIU",
        "first_name": "DWIGHT PETER",
        "middle_name": "LIM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME75674",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0075674",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43808",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254779100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction Medicine (Family Medicine) Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Addiction Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.