Timothy P Wombacher, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12692 Issued in TX

Practice address

1775 Dempster St
Park Ridge, IL 60068-1143

Phone

(708) 783-7025

Fax

(708) 783-7409

NPI assigned

May 14, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: twombacher335199@christushealth.direct-ci.net
• Direct secure messaging: timothy.wombacher@hca7.eclinicaldirectplus.com
• Direct secure messaging: twombacher1251452@direct.sw.org

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.

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  NPD (past)
• Saint Joseph Regional Medical Center, Inc.

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1518226356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11970 N CENTRAL EXPY STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433784",
            "telephone_number": "214-575-5885",
            "fax_number": "907-782-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681143",
            "telephone_number": "708-783-7025",
            "fax_number": "708-783-7409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11970 N Central Expy Ste 210",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752433784",
            "country_code": "US",
            "telephone_number": "214-575-5885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3537 S Interstate 35 E Ste 220",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762106813",
            "country_code": "US",
            "telephone_number": "214-575-5885",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 St Francis Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054940",
            "country_code": "US",
            "telephone_number": "765-775-2800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 S Fleishel Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-525-2992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMBACHER",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085005389",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TIMOTHY.WOMBACHER@hca7.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "11970 N Central Expy Ste 210",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752433784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Wolff, DPT, PT
• Laura Wolff
• Kathryn Wolford, MD
• Margaret A Wolodko, M.D.
• Julia Wolosz
• Cody Wong, DMD
• Emelita Marguez Wong, DDS
• Connie Woo, DMD
• Carson Woodbury, MD, MPHIL
• Grant Woodside, MD

• Physician Assistant in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.