NPIMap

Individual provider Active NPI

Timothy M Tobin, MD

  • Internal Medicine Physician
  • Longview, TX
National Provider Identifier
1215904610
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K9919 Issued in TX
Practice address
2901 4TH St
Longview, TX 75605-5128
Phone
(903) 757-6042
Fax
(903) 232-8226
NPI assigned
Mar 3, 2006
Last updated
Nov 2, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K9919 TX Primary

Addresses

Primary practice location

2901 4TH St
Longview, TX 75605-5128

Mailing address

707 Hollybrook
Longview, TX 75605
Phone (903) 757-6042

Other identifiers 2

IdentifierTypeStateIssuer
044071101MedicaidTX
110204439OtherTXRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20091218000238 TX Practitioner - Internal Medicine 6709926967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Missouri, Columbia School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

2901 4TH St
Longview, TX 75605-5128
Phone (903) 758-1818

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Clinicians of East Texas Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Diagnostic Clinic of Longview PA Internal Medicine Past Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients
Longview Medical Center LP Past Accepting new patients

Locations

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

709 Hollybrook Dr
Ste 4500
Longview, TX 75605
Phone (903) 757-6042

805 Medical Cir
Longview, TX 75605
Phone (903) 232-8100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4
  • Direct secure messaging: timothy.tobin.1@23550.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1215904610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75605",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055128",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K9919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044071101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110204439",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.