Individual provider Active NPI

Timothy James Mooney Jr., MD

  • Anesthesiology Physician
  • Fort Sam Houston, TX
National Provider Identifier
1194987560
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
S5228 Issued in TX
Practice address
3551 Roger Brooke Dr
Sammc, Dept of Anesthesiology
Fort Sam Houston, TX 78234-4504
Phone
(734) 320-7817
NPI assigned
Jun 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X S5228 TX Primary
Anesthesiology Physician 207L00000X 246519 1 NY

Addresses

Primary practice location

3551 Roger Brooke Dr
Sammc, Dept of Anesthesiology
Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Sammc, Dept of Anesthesiology
Fort Sam Houston, TX 78234-4504
Phone (734) 320-7817

Other practice location 1

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210816003841 TX Practitioner - Anesthesiology 8022337732 Reassigns benefits to 3 organizations
I20260116000459 MI Practitioner - Anesthesiology 8022337732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

Merit-based Incentive Payment System (MIPS)

Final score
96.65 of 100Reported as group
Quality
83.62
Promoting interoperability
100
Improvement activities
40
Cost
78.03

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
246519 1NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates CurrentSince May 22, 2023 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Oct 1, 2021 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiology CurrentSince Aug 23, 2024 Accepting new patients
Spectrum Health Primary Care Partners Anesthesiology CurrentSince Feb 5, 2026 Accepting new patients
University of Texas Health Science Center at San Antonio Anesthesiology CurrentSince Oct 1, 2021 Accepting new patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Aug 23, 2024 Accepting new patients

Locations

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Interoperability endpoints

  • Direct secure messaging: tmooney430091@uhssa.direct-ci.com

Organizations & group practices 7

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 2

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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1194987560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "SAMMC, DEPT OF ANESTHESIOLOGY",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "734-320-7817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "SAMMC, DEPT OF ANESTHESIOLOGY",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "734-320-7817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-358-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "S5228",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "246519 1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.