Timothy Charles Peck, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

280756 Issued in NY

Practice address

734 Webster St
D
Palo Alto, CA 94301-2630

Phone

(617) 317-8913

NPI assigned

Jun 17, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Emergency Medicine

Education

New York University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Physicians Associates PCGroup PAC ID 6709122724, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Emergency Medicine Physicians Associates PC

  • Emergency Medicine Physician
  • Jeffersonville, IN
  • NPI 1942775879
  Medicare reassignment Care Compare group NPD
• Norton Clark Hospital, LLC

  • General Acute Care Hospital
  • Jeffersonville, IN
  • NPI 1134186315
  NPD (past)

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

• Norton Clark Hospital, LLC

  • General Acute Care Hospital
  • Jeffersonville, IN
  • NPI 1134186315
  Care Compare affiliation

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437782400000",
    "number": "1508151473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 WEBSTER ST",
            "address_2": "D",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012630",
            "telephone_number": "516-317-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 WEBSTER ST",
            "address_2": "D",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943012630",
            "telephone_number": "617-317-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "TIMOTHY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2015-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "258649",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "280756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Payrovi, MD
• PCRT Palo Alto Psychotherapy for Complex and Relational Trauma
• Cecilia Ann Peabody, M.D.
• Dakota James Samuel Justin Peacock, MD
• Rotem Pearlson
• Melanie Peddle, M.S., CMT
• Maren Liv Pedersen, MD
• Martha Carey Pedersen, NP
• Julia Pederson
• Laia Pedreno Mateu

• Emergency Medicine Physician in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.