NPIMap

Individual provider Active NPI

Timothy Green, M.D.

  • Internal Medicine Physician
  • Nowata, OK
National Provider Identifier
1457739039
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31695 Issued in OK
Practice address
1020 Lenape Dr
Nowata, OK 74048
Phone
(918) 273-0192
Fax
(918) 273-0194
NPI assigned
May 14, 2015
Last updated
Sep 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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 31695 OK Primary

Addresses

Primary practice location

1020 Lenape Dr
Nowata, OK 74048

Mailing address

1020 Lenape Dr
Nowata, OK 74048-4403
Phone (918) 273-0192

Other practice location 1

7501 S Riverside Pkwy
Tulsa, OK 74136
Phone (918) 710-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161122000803 OK Practitioner - Family Practice 9931497914 Reassigns benefits to 2 organizations
I20181206002915 TX Practitioner - Family Practice 9931497914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

1020 Lenape Dr
Nowata, OK 74048-4403
Phone (918) 273-0192

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Oct 10, 2018 Accepting new patients
St. John Physicians, Inc CurrentSince Sep 24, 2016 Accepting new patients
Cherokee Nation CurrentSince Oct 10, 2018 Accepting new patients
Cherokee Nation Current Accepting new patients
St. John Physicians, Inc. Internal Medicine CurrentSince Sep 24, 2016 Accepting new patients
Cherokee Nation Current Accepting new patients
Hospital Care Consultants Region II Inc Internal Medicine CurrentSince Mar 19, 2017 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

1801 W 3rd St
Elk City, OK 73644
Phone 40584358551407

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

501 N 14th St
Perry, OK 73077
Phone (580) 336-3541

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 11

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 6

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": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1457739039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 LENAPE DR",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740484403",
            "telephone_number": "918-273-0192",
            "fax_number": "918-273-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 LENAPE DR",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "74048",
            "telephone_number": "918-273-0192",
            "fax_number": "918-273-0194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7501 S Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "74136",
            "country_code": "US",
            "telephone_number": "918-710-4200",
            "fax_number": "918-293-3155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "31695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nowata, OK

Sources for this page

Verify at the official NPI Registry.