Individual provider Active NPI

Timothy Ted Hopkins, DDS, MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Twin Falls, ID
National Provider Identifier
1376689646
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D3944-OS Issued in ID
Practice address
590 Falls Ave
Twin Falls, ID 83301-3314
Phone
(208) 733-1182
Fax
(208) 733-3341
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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 D3944-OS ID Primary

Addresses

Primary practice location

590 Falls Ave
Twin Falls, ID 83301-3314

Mailing address

590 Falls Ave
Twin Falls, ID 83301-3314
Phone (208) 733-1182

Other identifiers 5

IdentifierTypeStateIssuer
000010157302OtherIDBLUE SHIELD OF IDAHO
807501100MedicaidID
6P081OtherIDBLUE CROSS MEDICAL
6P082OtherIDBLUE CROSS DENTAL
807513800MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20070625000743 ID Practitioner - Oral Surgery 4981703311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Oral and Maxillofacial Surgery, PCGroup PAC ID 5890894224, 2 clinicians

Practice addresses (Care Compare)

801 Pole Line W Rd
Twin Falls, ID 83301-5810
Phone (208) 814-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D3944-OSIDMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Oral & Maxillofacial Surgery, PC CurrentSince Jan 2, 2007 Accepting new patients

Locations

590 Falls Ave
Twin Falls, ID 83301
Phone (208) 733-1182

801 Pole Line Rd W
Twin Falls, ID 83301
Phone (208) 814-1000

Organizations & group practices 1

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1376689646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013314",
            "telephone_number": "208-733-1182",
            "fax_number": "208-733-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 FALLS AVE",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013314",
            "telephone_number": "208-733-1182",
            "fax_number": "208-733-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKINS",
        "first_name": "TIMOTHY",
        "middle_name": "TED",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D3944-OS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010157302",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807501100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MEDICAL",
            "identifier": "6P081",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DENTAL",
            "identifier": "6P082",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807513800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.