Individual provider Active NPI

Timothy A Tierney, M.D.

  • Family Medicine Physician
  • Melrose, MA
National Provider Identifier
1306989066
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74751 Issued in MA
Practice address
675 Main St
Melrose, MA 02176-3138
Phone
(781) 662-4934
Fax
(781) 662-4711
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 74751 MA Primary

Addresses

Primary practice location

675 Main St
Melrose, MA 02176-3138

Mailing address

675 Main St
Melrose, MA 02176-3138
Phone (781) 662-4934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050414000703 MA Practitioner - Family Practice 4880582782 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74751MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
Dr Jennifer S Wu PC Past Accepting new patients

Locations

675 Main St
Melrose, MA 02176
Phone (781) 662-4934

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

1715 Broadway
Saugus, MA 01906
Phone (781) 233-2931

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.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1306989066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763138",
            "telephone_number": "781-662-4934",
            "fax_number": "781-662-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763138",
            "telephone_number": "781-662-4934",
            "fax_number": "781-662-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "74751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.