Individual provider Active NPI

Timothy Jared Reseigh, PA

  • Surgical Physician Assistant
  • Vail, CO
National Provider Identifier
1174776355
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2692 Issued in CO
Practice address
181 W Meadow Dr Ste 400
Vail, CO 81657-5058
Phone
(970) 476-1100
Fax
(970) 479-5835
NPI assigned
Oct 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2692 CO Primary

Addresses

Primary practice location

181 W Meadow Dr Ste 400
Vail, CO 81657-5058

Mailing address

181 W Meadow Dr
Ste 400
Vail, CO 81657-5058
Phone (970) 476-1100

Other identifiers 1

IdentifierTypeStateIssuer
41126564MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090210000041 CO Practitioner - Physician Assistant 3870658776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steadman Clinic Professional LLCGroup PAC ID 7719876226, 77 clinicians

Practice addresses (Care Compare)

181 W Meadow Dr
Suite 400
Vail, CO 81657-5058
Phone (970) 476-1100

Hospital & facility affiliations

  • Vail Health Hospital Hospital, Vail, CO, CCN 060096

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steadman Clinic Professional LLC CurrentSince Aug 1, 2019 Accepting new patients

Locations

401 Castle Creek Rd
Ste 2100
Aspen, CO 81611
Phone (970) 544-1289

200 Robinson St
Ste C300
Basalt, CO 81621

322 Beard Creek Rd
Edwards, CO 81632
Phone (970) 569-7429

181 W Meadow Dr
Ste 400
Vail, CO 81657
Phone (970) 680-0795

Organizations & group practices 1

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 5

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": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1174776355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 W MEADOW DR",
            "address_2": "STE 400",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575058",
            "telephone_number": "970-476-1100",
            "fax_number": "970-479-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 W MEADOW DR STE 400",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575058",
            "telephone_number": "970-476-1100",
            "fax_number": "970-479-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESEIGH",
        "first_name": "TIMOTHY",
        "middle_name": "JARED",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-31",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "2692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41126564",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vail, CO

Sources for this page

Verify at the official NPI Registry.