Active NPI
Deardourff Timmons & Associates PA
- Urology Physician
- Gainesville, FL
National Provider Identifier
1295768398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- ME79809
- Legal business name
- DEARDOURFF TIMMONS & ASSOCIATES PA
- Practice address
- 6420 NW 9TH Blvd
Gainesville, FL 32605-4203 - Phone
- (352) 331-2332
- Fax
- (352) 331-6515
- NPI assigned
- Jul 9, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Christopher M Cassisi, MD
- Title
- Secretary
- Phone
- (352) 331-2332
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 11
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Acute Care Nurse Practitioner
- Gainesville, FL
- NPI 1942322912
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0865531 | Deardourff, Timmons & Associates, PA | Certificate of waiver | Jan 17, 2027 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061220000009 | FL | Part B Supplier - Clinic/Group Practice | 3274532270 |
Receives reassigned benefits from 9 practitioners Practice locations: Gainesville, FL |
National Provider Directory
National Provider DirectoryLocations
6420 NW 9th Blvd
Gainesville, FL 32605
Phone (352) 331-2332
6420 NW 9th Blvd
Ste 2
Gainesville, FL 32605
Phone (352) 331-2332
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | ME79809 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
6420 NW 9TH Blvd
Gainesville, FL 32605-4203
Mailing address
6420 NW 9TH Blvd
Gainesville, FL 32605-4203
Phone (352) 331-2332
Other identifiers 5
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71048 | Other | FL | BCBS PROVIDER NUMBER |
| 260934700 | Medicaid | FL | |
| 53219 | Other | FL | BCBS PROVIDER NUMBER |
| 51898 | Other | FL | BCBS PROVIDER NUMBER |
| 01228 | Other | FL | BCBS PROVIDER NUMBER |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 21, 2025.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1747785600000",
"number": "1295768398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6420 NW 9TH BLVD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326054203",
"telephone_number": "352-331-2332",
"fax_number": "352-331-6515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6420 NW 9TH BLVD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326054203",
"telephone_number": "352-331-2332",
"fax_number": "352-331-6515"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DEARDOURFF TIMMONS & ASSOCIATES PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-09",
"last_updated": "2025-05-21",
"certification_date": "2025-05-21",
"status": "A",
"authorized_official_last_name": "CASSISI",
"authorized_official_first_name": "CHRISTOPHER",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "352-331-2332",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "FL",
"license": "ME79809",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "71048",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "260934700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "53219",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "51898",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "01228",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.