Individual provider Active NPI

Timothy Gerard McAvoy, MD

  • Internal Medicine Physician
  • Waukesha, WI
National Provider Identifier
1396792255
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22122 Issued in WI
Practice address
1751 E Main St
Waukesha, WI 53186-3940
Phone
(262) 547-0000
Fax
(262) 547-0157
NPI assigned
May 27, 2006
Last updated
Dec 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22122 WI Primary

Addresses

Primary practice location

1751 E Main St
Waukesha, WI 53186-3940

Mailing address

1751 E Main St
Waukesha, WI 53186-3940
Phone (262) 547-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20120111000945 WI Practitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 6800063066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Physical Medicine and Rehabilitation
Education
New York Medical College, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy G McAvoy MD SCGroup PAC ID 9739356999, 2 clinicians

Practice addresses (Care Compare)

1751 E Main St
Waukesha, WI 53186-3940
Phone (262) 547-0000

222 Park PL
Waukesha, WI 53186-4858
Phone (651) 631-6570

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22122WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy G McAvoy MD SC Internal Medicine CurrentSince Jan 13, 2012 Accepting new patients

Locations

1625 Coldwater Creek Dr
Waukesha, WI 53188
Phone (262) 521-8800

1751 E Main St
Waukesha, WI 53186
Phone (262) 544-1755

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

Interoperability endpoints

  • Direct secure messaging: tmcavoy14819@direct.phci.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1396792255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 E MAIN ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863940",
            "telephone_number": "262-547-0000",
            "fax_number": "262-547-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 E MAIN ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531863940",
            "telephone_number": "262-547-0000",
            "fax_number": "262-547-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCAVOY",
        "first_name": "TIMOTHY",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "22122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.