NPIMap

Individual provider Active NPI

Timothy P Vanderbilt, M.D.

  • Orthopaedic Surgery Physician
  • Madison, WI
National Provider Identifier
1548403231
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
102696 Issued in AK
Practice address
1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone
(608) 252-8000
Fax
(608) 288-6495
NPI assigned
Apr 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 55868-20 WI
Orthopaedic Surgery Physician 207X00000X 17227 NV
Orthopaedic Surgery Physician 207X00000X 102696 AK Primary

Addresses

Primary practice location

1211 Fish Hatchery Rd
Madison, WI 53715-1909

Mailing address

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

Other identifiers 1

IdentifierTypeStateIssuer
1548403231MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tvanderbilt387418@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MT2 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
I20210128000101 WI Practitioner - Orthopedic Surgery 4385877901 Reassigns benefits to 3 organizations
I20230601001518 MT Practitioner - Orthopedic Surgery 4385877901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians
Stoughton Hospital AssociationGroup PAC ID 7012825706, 66 clinicians

Practice addresses (Care Compare)

1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000

900 Ridge St
Stoughton, WI 53589-1864
Phone (608) 873-6611

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Removal of tissue17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102696AKMDOrthopaedic Surgery Physician
55868-20WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic CurrentSince Jun 1, 2023 Accepting new patients
Billings Clinic Current Accepting new patients
Stoughton Hospital Association CurrentSince Jul 4, 2023 Accepting new patients
Dean Health Systems, Inc CurrentSince Jan 18, 2021 Accepting new patients
Billings Clinic CurrentSince Jun 1, 2023 Accepting new patients
Stoughton Hospital Association CurrentSince Jul 4, 2023 Accepting new patients
Dean Health Systems, Inc. CurrentSince Jan 18, 2021 Accepting new patients

Locations

2702 8th Ave N
Billings, MT 59101
Phone (406) 238-2769

2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290

2501 W Beltline Hwy
Ste 601
Madison, WI 53713
Phone (608) 234-7436

1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

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 8

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": "1239408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1548403231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-288-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 FISH HATCHERY RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151909",
            "telephone_number": "608-252-8000",
            "fax_number": "608-288-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBILT",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-11",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "55868-20",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NV",
            "license": "17227",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AK",
            "license": "102696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548403231",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tvanderbilt387418@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tvanderbilt387418@direct-ehr-ssmhc.com",
            "address_1": "2501 W Beltline Hwy Ste 601",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537132309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2501 W Beltline Hwy Ste 601",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537132309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.