Individual provider Active NPI

Timothy G Timmerman, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Dubuque, IA
National Provider Identifier
1265405781
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
31521 Issued in IA
Practice address
250 Mercy Dr
Dubuque, IA 52004-0731
Phone
(563) 589-9615
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 31521 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 31521 IA Primary

Addresses

Primary practice location

250 Mercy Dr
Dubuque, IA 52004-0731

Mailing address

250 Mercy Dr
P O Box 731
Dubuque, IA 52004-0731
Phone (563) 589-8616

Other identifiers 1

IdentifierTypeStateIssuer
40613OtherIABCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20060501000407 IA Practitioner - Pathology 8729098157 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Iowa, RJ & L Carver College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical Center-DubuqueGroup PAC ID 2668467168, 20 clinicians

Practice addresses (Care Compare)

150 Mercy Dr
Mercyone Dubuque Cancer Center
Dubuque, IA 52001-7320
Phone (563) 589-8024

250 Mercy Dr
Dubuque, IA 52001-7320
Phone (563) 589-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31521IAMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center-Dubuque CurrentSince Nov 4, 2023 Accepting new patients
Mercy Medical Center-Dyersville CurrentSince Nov 4, 2023 Accepting new patients
Mercy Medical Center-Dubuque CurrentSince Nov 4, 2023 Accepting new patients

Locations

250 Mercy Dr
Dubuque, IA 52001
Phone (563) 589-8000

250 Mercy Dr
Rm G211
Dubuque, IA 52001
Phone (563) 556-2012

1111 3rd St SW
Dyersville, IA 52040
Phone (563) 875-2953

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 and National Provider Directory roles.

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1265405781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MERCY DR",
            "address_2": "P O BOX 731",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520040731",
            "telephone_number": "563-589-8616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MERCY DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520040731",
            "telephone_number": "563-589-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMERMAN",
        "first_name": "TIMOTHY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "IA",
            "license": "31521",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "31521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "40613",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

Verify at the official NPI Registry.