Individual provider Active NPI

Timothy Scott Bartholomew, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Mansfield, OH
National Provider Identifier
1306077656
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
30021308 Issued in OH
Practice address
630 Lexington Ave
Mansfield, OH 44907-1500
Phone
(419) 756-0711
NPI assigned
Aug 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30021308 OH Primary

Addresses

Primary practice location

630 Lexington Ave
Mansfield, OH 44907-1500

Mailing address

630 Lexington Ave
Mansfield, OH 44907-1500
Phone (419) 756-0711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240429000518 OH Practitioner - Oral Surgery 8921300401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30021308OHMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Lorain County Health & Dentistry CurrentSince Apr 16, 2024 Accepting new patients
Lorain County Health & Dentistry CurrentSince Apr 16, 2024 Accepting new patients
Oral Surgical Institute, P.C. Oral and Maxillofacial Surgery PastSince Apr 30, 2023 Accepting new patients
Oral Surgical Institute, P.C. Past Accepting new patients

Locations

1205 Broadway
Lorain, OH 44052

Interoperability endpoints

  • Direct secure messaging: timothy.bartholomew.p11@direct.loraincountyhealth.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1306077656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071500",
            "telephone_number": "419-756-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071500",
            "telephone_number": "419-756-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30021308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.