Individual provider Active NPI

Mitchell Allen Timmons, D.O.

  • Cardiovascular Disease Physician
  • Milwaukee, WI
National Provider Identifier
1285806182
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
59029 Issued in MN
Practice address
9200 W Wisconsin Ave
Department of Internal Medicine
Milwaukee, WI 53226-3522
Phone
(414) 805-6850
Fax
(414) 805-6851
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 54276 WI
Cardiovascular Disease Physician 207RC0000X 59029 MN Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Department of Internal Medicine
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Department of Internal Medicine
Milwaukee, WI 53226-3522
Phone (414) 805-6850

Other practice location 1

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 625-3600

Other identifiers 1

IdentifierTypeStateIssuer
1285806182MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110727000626 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3173791621 Reassigns benefits to 2 organizations
I20150716000957 MN Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3173791621 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Winona Health ServicesGroup PAC ID 8527977420, 160 clinicians

Practice addresses (Care Compare)

1390 University Ave W
Saint Paul, MN 55104-4001
Phone (651) 232-4800

2651 Hillcrest Dr
Suite 302
Hudson, WI 54016-9919
Phone (612) 365-5000

319 S Main St
River Falls, WI 54022-2452
Phone (715) 425-6701

606 24TH Ave S
Minneapolis, MN 55454-1455
Phone (612) 884-0649

6401 France Ave S
Edina, MN 55435-2104
Phone (800) 468-3120

855 Mankato Ave
Winona, MN 55987-4868
Phone (507) 454-3650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54276WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Bethesda Hospital CurrentSince Jul 27, 2015 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Apr 15, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Jun 15, 2022 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Care System CurrentSince Jul 27, 2015 Accepting new patients
Fairview Clinics CurrentSince Apr 15, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Nov 14, 2020 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Jul 27, 2015 Accepting new patients
Fairview Express Care CurrentSince Oct 19, 2020 Accepting new patients
Winona Health Services CurrentSince Dec 29, 2020 Accepting new patients
Fairview Clinics CurrentSince Apr 15, 2020 Accepting new patients
Fairview Express Care CurrentSince Oct 19, 2020 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Jul 27, 2015 Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

400 Stinson Blvd
Minneapolis, MN 55413
Phone (612) 672-2258

2849 Johnson St NE
Minneapolis, MN 55418
Phone (612) 672-1900

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

2651 Hillcrest Dr
Ste 302
Hudson, WI 54016
Phone (651) 241-5290

319 S Main St
River Falls, WI 54022
Phone (715) 425-6701

1687 E Division St
River Falls, WI 54022
Phone (715) 425-6701

Interoperability endpoints

  • Direct secure messaging: mtimmons502273@fairview.direct-ci.com

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 6

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": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1285806182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF INTERNAL MEDICINE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Fulton St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554554800",
            "country_code": "US",
            "telephone_number": "612-625-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "MITCHELL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "54276",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "59029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285806182",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.