NPIMap

Individual provider Active NPI

Timothy John Labonte, MD

  • Family Medicine Physician
  • Marquette, MI
National Provider Identifier
1154617603
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301098841 Issued in MI
Practice address
1414 W Fair Ave
Suite 36
Marquette, MI 49855-2675
Phone
(906) 225-3864
NPI assigned
Jun 23, 2011
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 4301098841 MI Primary

Addresses

Primary practice location

1414 W Fair Ave
Suite 36
Marquette, MI 49855-2675

Mailing address

4602 Dept
Carol Stream, IL 60122-4602
Phone (906) 225-3864

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130819000171 MI Practitioner - Family Practice 4688816853 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus KeweenawGroup PAC ID 8123912011, shared by 7 NPIs, 116 clinicians
Portage Physician Practices IncGroup PAC ID 6103053509, 56 clinicians

Practice addresses (Care Compare)

205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100

500 Campus Dr
Hancock, MI 49930-1452

921 W Sharon Ave
Houghton, MI 49931-1921
Phone (906) 483-1777

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince May 1, 2013 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Family Medicine CurrentSince Jun 24, 2014 Accepting new patients
Portage Physician Practices Inc CurrentSince Jul 26, 2014 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince May 1, 2013 Accepting new patients
Portage Physician Practices Inc Family Medicine CurrentSince Jul 26, 2014 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Family Medicine CurrentSince Jun 24, 2014 Accepting new patients
DLP Marquette Physician Practices Inc Family Medicine Current Accepting new patients
Portage Hospital LLC Past Accepting new patients

Locations

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

945 9th St
Lake Linden, MI 49945
Phone (906) 483-1000

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

Interoperability endpoints

  • Direct secure messaging: timothy.labonte.1@8233.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Up Health System PortageHancock, MI, CCN 230108 Hospital Other May 7, 2020
Up Health System PortageHancock, MI, CCN 23U108 Hospital Other May 7, 2020
PortagepointeHancock, MI, CCN 235624 Skilled nursing facility Other May 7, 2020

Owned or controlled facilities with NPI records 3

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

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1308787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1154617603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 DEPT",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601224602",
            "telephone_number": "906-225-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 W FAIR AVE",
            "address_2": "SUITE 36",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552675",
            "telephone_number": "906-225-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABONTE",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-23",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301098841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.