NPIMap

Individual provider Active NPI

Timothy Hogan, DO

  • Family Medicine Physician
  • Montoursville, PA
National Provider Identifier
1245767219
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS019647 Issued in PA
Practice address
780 Broad St
Montoursville, PA 17754-2419
Phone
(570) 368-2870
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OT017891 PA
General Practice Physician 208D00000X OS019647 PA
Family Medicine Physician 207Q00000X OS019647 PA Primary

Addresses

Primary practice location

780 Broad St
Montoursville, PA 17754-2419

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thogan280105@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20190211001135 PA Practitioner - Family PracticePractitioner - Emergency Medicine 1951664911 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6144

157 Roosevelt Ave
Selinsgrove, PA 17870-7961
Phone (570) 884-3726

25 Church St
Wilkes Barre, PA 18702-3507
Phone (570) 808-3181

410 Glen Ave
Bloomsburg, PA 17815-1200
Phone (570) 416-1890

Hospital & facility affiliations

  • Geisinger Wyoming Valley Medical Center Hospital, Wilkes Barre, PA, CCN 390270
  • Geisinger-Bloomsburg Hospital Hospital, Bloomsburg, PA, CCN 390003
  • Geisinger Medical Center Hospital, Danville, PA, CCN 390006
  • Wellspan Evangelical Community Hospital Hospital, Lewisburg, PA, CCN 390013
  • Geisinger-Community Medical Center Hospital, Scranton, PA, CCN 390001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS019647PAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Family Medicine Current Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Aug 3, 2020 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. CurrentSince Feb 1, 2019 Accepting new patients
Geisinger Clinic Family Medicine CurrentSince Aug 3, 2020 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Current Accepting new patients
Geisinger-HM Joint Venture, LLC Family Medicine CurrentSince Aug 3, 2020 Accepting new patients
Geisinger Clinic CurrentSince Aug 3, 2020 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

780 Broad St
Montoursville, PA 17754
Phone (570) 368-2870

157 Roosevelt Ave
Selinsgrove, PA 17870
Phone (570) 884-3726

611 University Dr
State College, PA 16801
Phone (814) 234-2600

809 Hunter Hwy
Tunkhannock, PA 18657
Phone (570) 966-2700

25 Church St
Wilkes Barre, PA 18702
Phone (570) 340-5800

Interoperability endpoints

  • Direct secure messaging: thogan280105@direct.geisinger.edu

Organizations & group practices 8

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 59

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1245767219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 BROAD ST",
            "city": "MONTOURSVILLE",
            "state": "PA",
            "postal_code": "177542419",
            "telephone_number": "570-368-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "TIMOTHY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT017891",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "OS019647",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS019647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thogan280105@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "780 Broad St",
            "city": "Montoursville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "177542419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Montoursville, PA

Sources for this page

Verify at the official NPI Registry.