Individual provider Active NPI

Timothy J Decapite, MD

  • Dermatology Physician
  • Tuba City, AZ
National Provider Identifier
1194868356
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D68599 Issued in MD
Practice address
167 N Main St
Tuba City, AZ 86045
Phone
(928) 283-2501
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D68599 MD Primary

Addresses

Primary practice location

167 N Main St
Tuba City, AZ 86045

Mailing address

PO Box 600
Tuba City, AZ 86045-0600
Phone (928) 283-2501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100929001403 TX Practitioner - Dermatology 2466505391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Maryland School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

167 Main St
Tcrhcc Mobile Medical Clinic
Tuba City, AZ 86045-0600
Phone (928) 283-2501

167 N Main St
Tuba City, AZ 86045-0600
Phone (928) 283-2094

P O Box
Suite 600
Tuba City, AZ 86045-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.59 of 100Reported as group
Quality
47.51
Promoting interoperability
69
Improvement activities
40
Cost
86.96

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions29
Removal or shaving of skin growth1-10
Skin biopsy23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D68599MDMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuba City Regional Health Care Corporation Family Medicine CurrentSince Sep 13, 2010 Accepting new patients
Tuba City Regional Health Care Corporation Family Medicine CurrentSince Sep 13, 2010 Accepting new patients
Englert Dermatology, LLC Dermatology Past Accepting new patients
Englert Dermatology LLC Dermatology Past Accepting new patients

Organizations & group practices 4

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 1

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1194868356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 N MAIN ST",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "86045",
            "telephone_number": "928-283-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECAPITE",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D68599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuba City, AZ

Sources for this page

Verify at the official NPI Registry.