Individual provider Active NPI

Tim John Lee Ochoa, DO

  • Emergency Medicine Physician
  • St Maries, ID
National Provider Identifier
1609164417
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
O-0978 Issued in ID
Practice address
229 S 7TH St
St Maries, ID 83861-1803
Phone
(208) 245-5551
Fax
(208) 245-5246
NPI assigned
Jul 13, 2011
Last updated
Sep 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X O-0978 ID Primary
Family Medicine Physician 207Q00000X O-0978 ID
Hospitalist Physician 208M00000X O-0978 ID

Addresses

Primary practice location

229 S 7TH St
St Maries, ID 83861-1803

Mailing address

229 S 7TH St
St Maries, ID 83861-1803
Phone (208) 245-5551

Other practice location 1

25 Jacobs Gulch Rd
Kellogg, ID 83837-2023
Phone (208) 784-1221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20160929002359 ID Practitioner - Family Practice 6608192158 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benewah Community HospitalGroup PAC ID 1850200700, shared by 2 NPIs, 39 clinicians

Practice addresses (Care Compare)

229 S 7TH St
St Maries, ID 83861-1803

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-0978IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shoshone Medical Center CurrentSince Sep 1, 2016 Accepting new patients
Shoshone Medical Center Family Medicine CurrentSince Sep 1, 2016 Accepting new patients

Locations

25 Jacobs Gulch Rd
Kellogg, ID 83837
Phone (208) 784-1221

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9a0a9763-cc6e-4ca0-bdec-c16291c965b9/

Organizations & group practices 4

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": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1609164417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 S 7TH ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611803",
            "telephone_number": "208-245-5551",
            "fax_number": "208-245-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 S 7TH ST",
            "city": "ST MARIES",
            "state": "ID",
            "postal_code": "838611803",
            "telephone_number": "208-245-5551",
            "fax_number": "208-245-5246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Jacobs Gulch Rd",
            "address_purpose": "LOCATION",
            "city": "Kellogg",
            "state": "ID",
            "postal_code": "838372023",
            "country_code": "US",
            "telephone_number": "208-784-1221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OCHOA",
        "first_name": "TIM",
        "middle_name": "JOHN LEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-0978",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-0978",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ID",
            "license": "O-0978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Maries, ID

Sources for this page

Verify at the official NPI Registry.