Individual provider Active NPI

Katelynn Marie Timony, PA-C

  • Physician Assistant
  • Hamburg, NJ
National Provider Identifier
1205447968
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
17 State RT 23 N
Hamburg, NJ 07419-1419
Phone
(973) 827-7800
Fax
(973) 209-7855
NPI assigned
Aug 14, 2020
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

17 State RT 23 N
Hamburg, NJ 07419-1419

Mailing address

LB# 7550, P.O. Box 95000
Philadelphia, PA 19195-7550
Phone (844) 362-1735

Other practice location 1

254B Mountain Ave Ste 100
Hackettstown, NJ 07840-2413
Phone (908) 852-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20210826000219 NJ Practitioner - Physician Assistant 3779988936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Partners LLCGroup PAC ID 2860665809, 74 clinicians

Practice addresses (Care Compare)

254 B Mountain Ave
Suite 304
Hackettstown, NJ 07840-2413
Phone (908) 852-6400

475 S St
Morristown, NJ 07960-6459
Phone (973) 971-5000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Partners, LLC CurrentSince Sep 1, 2021 Accepting new patients
Primary Care Partners, LLC Physician Assistant Past Accepting new patients
Primary Care Partners, LLC Past Accepting new patients

Locations

17 State Rt 23 N
Hamburg, NJ 07419
Phone (973) 827-7800

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

475 South St
Morristown, NJ 07960
Phone (973) 660-3166

Organizations & group practices 3

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 4

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": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1205447968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LB# 7550, P.O. BOX 95000",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191957550",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 STATE RT 23 N",
            "city": "HAMBURG",
            "state": "NJ",
            "postal_code": "074191419",
            "telephone_number": "973-827-7800",
            "fax_number": "973-209-7855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "254B Mountain Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hackettstown",
            "state": "NJ",
            "postal_code": "078402413",
            "country_code": "US",
            "telephone_number": "908-852-6400",
            "fax_number": "908-852-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMONY",
        "first_name": "KATELYNN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NJ

Sources for this page

Verify at the official NPI Registry.