Individual provider Active NPI

Timothy J Eddy, DO

  • Family Medicine Physician
  • Gardner, MA
National Provider Identifier
1376549584
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80830 Issued in MA
Practice address
529 Timpany Blvd
Gardner, MA 01440-3451
Phone
(978) 878-8100
Fax
(978) 410-6109
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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 80830 MA Primary

Addresses

Primary practice location

529 Timpany Blvd
Gardner, MA 01440-3451

Mailing address

529 Timpany Blvd
Gardner, MA 01440-3451
Phone (978) 878-8100

Other identifiers 3

IdentifierTypeStateIssuer
221868OtherUGS
1320815MedicaidMA
M18970OtherMABLUE SHIELD OF MA

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
I20050615000988 MA Practitioner - Family Practice 4880638311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1991
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

175 Connors St
Gardner, MA 01440-2637
Phone (978) 410-6100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Apr 1, 2015 Accepting new patients
Community Health Connections, Inc. CurrentSince Dec 15, 2022 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2015 Accepting new patients
Heywood Medical Group Inc. Family Medicine CurrentSince May 9, 2013 Accepting new patients
Convenientmd LLC Past Accepting new patients
Community Health Connections, Inc. Past Accepting new patients
David C. Flemming MD PLLC Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

326 Nichols Rd
Fitchburg, MA 01420
Phone (978) 343-5270

266 Main St
Gardner, MA 01440
Phone (978) 630-5030

250 Green St
Ste 205A
Gardner, MA 01440
Phone (978) 630-5751

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

175 Connors St
Gardner, MA 01440
Phone (978) 410-6100

Organizations & group practices 8

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1376549584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 TIMPANY BLVD",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403451",
            "telephone_number": "978-878-8100",
            "fax_number": "978-410-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 TIMPANY BLVD",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014403451",
            "telephone_number": "978-878-8100",
            "fax_number": "978-410-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "80830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UGS",
            "identifier": "221868",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1320815",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MA",
            "identifier": "M18970",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.