Individual provider Active NPI

Timothy B Mooney, M.D.

  • Emergency Medicine Physician
  • Manhasset, NY
National Provider Identifier
1447412804
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
254255 Issued in NY
Practice address
300 Community Dr
Department of Emergency Medicine
Manhasset, NY 11030-3816
Phone
(516) 562-2925
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 254255 NY Primary

Addresses

Primary practice location

300 Community Dr
Department of Emergency Medicine
Manhasset, NY 11030-3816

Mailing address

304 Community Dr
1D
Manhasset, NY 11030-3834
Phone (631) 804-7862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101130000092 NY Practitioner - Emergency Medicine 3375739691 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Emergency Medical Services PCGroup PAC ID 4981503513, 138 clinicians

Practice addresses (Care Compare)

2215 Burdett Ave
Troy, NY 12180-2466
Phone (518) 271-3261

Hospital & facility affiliations

  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254255NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Island Emergency Medical Services, P.C. Emergency Medicine CurrentSince May 1, 2023 Accepting new patients
Ellis Hospital Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
Albany Medical College Emergency Medicine CurrentSince Jun 12, 2023 Accepting new patients
Albany Medical College Emergency Medicine CurrentSince Jun 12, 2023 Accepting new patients
Albany Medical College Emergency Medicine CurrentSince Jun 12, 2023 Accepting new patients
Ellis Hospital Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
Albany Medical College Emergency Medicine Current Accepting new patients

Locations

600 Northern Blvd
Albany, NY 12204
Phone (518) 427-3331

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

103 Sitterly Rd
Halfmoon, NY 12065
Phone (518) 579-2700

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1447412804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 COMMUNITY DR",
            "address_2": "1D",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303834",
            "telephone_number": "631-804-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COMMUNITY DR",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303816",
            "telephone_number": "516-562-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "254255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

Verify at the official NPI Registry.