Timothy S Cleary, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

13852 Issued in OR

Practice address

11786 SW Barnes Rd
Ste 270
Portland, OR 97225-5929

Phone

(503) 520-0777

Fax

(503) 520-0559

NPI assigned

Jun 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229472000000",
    "number": "1215933411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD",
            "address_2": "STE 270",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255929",
            "telephone_number": "503-520-0777",
            "fax_number": "503-520-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11786 SW BARNES RD",
            "address_2": "STE 270",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255929",
            "telephone_number": "503-520-0777",
            "fax_number": "503-520-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2008-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "13852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109009",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00156415",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradford Alan Cleary, LMT
• Daniel R Cleary
• Joshua Michael Cleary, DNP, PMHNP-BC
• Lauren E Cleary, LPC, ATR-BC
• Leasia Marie Cleary, LCSW
• Ashley Cleaver
• James Peyton Cleaver, LAC.
• Jessica Joy Cleaver, LMT
• Cheyenne A Cleeton, CADC I/QMHA-R
• Mark Clegg, LMT

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.