Individual provider Active NPI

Timothy J Mooney, M.D.

  • Gynecology Physician
  • Hammond, LA
National Provider Identifier
1295732774
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD.019931 Issued in LA
Practice address
42333 Deluxe PLZ
Suite 7
Hammond, LA 70403-1239
Phone
(985) 345-2555
Fax
(985) 345-2837
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD.019931 LA Primary

Addresses

Primary practice location

42333 Deluxe PLZ
Suite 7
Hammond, LA 70403-1239

Mailing address

807 Eden Oaks Dr
Ponchatoula, LA 70454-6389
Phone (985) 345-2555

Other identifiers 1

IdentifierTypeStateIssuer
1985368MedicaidLA

Other names 1

  • Mr. Timothy J Mooney Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20041025000313 LA Practitioner - Obstetrics/Gynecology 8921069840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Louisiana State University School of Medicine in New Orleans, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42333 Deluxe PLZ
Suite 7
Hammond, LA 70403-1239
Phone (985) 345-2555

Hospital & facility affiliations

  • North Oaks Medical Center Hospital, Hammond, LA, CCN 190015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.019931LAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy J. Mooney, M.D., L.L.C. Gynecology CurrentSince Oct 12, 2009 Accepting new patients
C. Markham Berry III, M.D., L.L.C. Gynecology Current Accepting new patients

Locations

42333 Deluxe Plz
Ste 7
Hammond, LA 70403
Phone (985) 345-2555

Organizations & group practices 2

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 1

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1295732774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 EDEN OAKS DR",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704546389",
            "telephone_number": "985-345-2555",
            "fax_number": "985-345-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42333 DELUXE PLZ",
            "address_2": "SUITE 7",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031239",
            "telephone_number": "985-345-2555",
            "fax_number": "985-345-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "LA",
            "license": "MD.019931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1985368",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIMOTHY",
            "last_name": "MOONEY",
            "middle_name": "J",
            "prefix": "MR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.