Individual provider Active NPI

Timothy Carlisle, PA

  • Medical Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1487752440
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004857 Issued in MI
Practice address
900 Peeler St
Kalamazoo, MI 49008-2300
Phone
(269) 342-7827
NPI assigned
Sep 20, 2006
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004857 MI
Medical Physician Assistant 363AM0700X 5601004857 MI Primary

Addresses

Primary practice location

900 Peeler St
Kalamazoo, MI 49008-2300

Mailing address

900 Peeler St
Kalamazoo, MI 49008-2300
Phone (269) 342-7827

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070109000098 MI Practitioner - Physician Assistant 3870593239 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, shared by 3 NPIs, 721 clinicians
Kalamazoo Anesthesiology P CGroup PAC ID 3375449473, 135 clinicians

Practice addresses (Care Compare)

601 John St
Kalamazoo, MI 49007-5377

7920 Kirkland CT
Portage, MI 49024-4974
Phone (269) 345-0669

900 Peeler St
Kalamazoo, MI 49008-2300
Phone (269) 345-8618

940 John St
Kalamazoo, MI 49001-2857
Phone (269) 552-4266

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
79.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601004857MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital Physician Assistant CurrentSince Dec 12, 2024 Accepting new patients
Bronson Battle Creek Hospital Physician Assistant CurrentSince Mar 1, 2025 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Mar 1, 2025 Accepting new patients
Bronson Battle Creek Hospital CurrentSince Mar 1, 2025 Accepting new patients
Battle Creek Emergency Physicians, PC Physician Assistant Past Accepting new patients
Calhoun County Emergency Physicians PC Past Accepting new patients

Locations

Dept CH 14260
Palatine, IL 60055

300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

5121 S Westnedge Ave
Portage, MI 49002
Phone (269) 337-2110

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

Hospital & facility affiliations 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1487752440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082300",
            "telephone_number": "269-342-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082300",
            "telephone_number": "269-342-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "TIMOTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004857",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.