Individual provider Active NPI

Timothy Sean Whitaker, MD

  • Surgery Physician
  • Oneonta, NY
National Provider Identifier
1255437588
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME161759 Issued in FL
Practice address
449 Main St
Oneonta, NY 13820-2028
Phone
(607) 432-5680
Fax
(607) 432-5575
NPI assigned
Sep 15, 2006
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME161759 FL Primary
Surgery Physician 208600000X 218885 NY

Addresses

Primary practice location

449 Main St
Oneonta, NY 13820-2028

Mailing address

PO Box 100707
Atlanta, GA 30384-0707
Phone (786) 594-6880

Other practice location 1

91550 Overseas Hwy Ste 214
Tavernier, FL 33070-2513
Phone (305) 271-9777

Other identifiers 1

IdentifierTypeStateIssuer
03157782MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TIM08874@cerner.directbaptisthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231017000692 FL Practitioner - General Surgery 4587630579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of South Florida College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

91550 Overseas Hwy
Suite 214
Tavernier, FL 33070-2513
Phone (305) 271-9777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy31
Hernia repair - groin (open)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Upper Keys, LLC CurrentSince Oct 1, 2023 Accepting new patients
Baptist Health Medical Group Upper Keys, LLC CurrentSince Oct 1, 2023 Accepting new patients
Blue Ridge Surgical, Inc Surgery PastSince Apr 9, 2004 Accepting new patients

Locations

91550 Overseas Hwy
Ste 205
Tavernier, FL 33070
Phone (305) 434-3400

91550 Overseas Hwy
Ste 214
Tavernier, FL 33070
Phone (305) 852-2089

Interoperability endpoints

  • Direct secure messaging: tim08874@cerner.directbaptisthealth.com

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 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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1255437588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100707",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840707",
            "telephone_number": "786-594-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 MAIN ST",
            "city": "ONEONTA",
            "state": "NY",
            "postal_code": "138202028",
            "telephone_number": "607-432-5680",
            "fax_number": "607-432-5575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91550 Overseas Hwy Ste 214",
            "address_purpose": "LOCATION",
            "city": "Tavernier",
            "state": "FL",
            "postal_code": "330702513",
            "country_code": "US",
            "telephone_number": "305-271-9777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "TIMOTHY",
        "middle_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME161759",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "218885",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03157782",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TIM08874@cerner.directbaptisthealth.com",
            "affiliation": "N",
            "address_1": "91550 Overseas Hwy Ste 214",
            "city": "Tavernier",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330702513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oneonta, NY

Sources for this page

Verify at the official NPI Registry.