Individual provider Active NPI

Timothy M Anderson, M.D.

  • Addiction Medicine (Internal Medicine) Physician
  • Lake Worth, FL
National Provider Identifier
1316063357
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
ME32575 Issued in FL
Practice address
120 N Federal Hwy
Lake Worth, FL 33460-3403
Phone
(888) 400-1556
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X ME32575 FL
Occupational Medicine Physician 2083X0100X 32575 FL
Addiction Medicine (Internal Medicine) Physician 207RA0401X ME32575 FL Primary

Addresses

Primary practice location

120 N Federal Hwy
Lake Worth, FL 33460-3403

Mailing address

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 420-8555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME32575FLMDPreventive Medicine/Occupational Environmental Medicine Physician
32575FLMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Detox of South Florida, LLC Past Accepting new patients
Treatment Solutions of So Florida, Inc Past Accepting new patients

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1316063357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-420-8555",
            "fax_number": "888-442-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N FEDERAL HWY",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334603403",
            "telephone_number": "888-400-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "FL",
            "license": "ME32575",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "FL",
            "license": "32575",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME32575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.