Tim K Puckett, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

ME93795 Issued in FL

Practice address

8110 Royal Palm Blvd
Ste 108
Coral Springs, FL 33065-5795

Phone

(954) 341-8288

Fax

(954) 341-5156

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Obstetrics/Gynecology

Education

Uniformed Services Uhs Fe Hebert School of Med, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

OB Hospitalist Group LLCGroup PAC ID 5193866838, 127 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tim.puckett@hca4.eclinicaldirectplus.com

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.

• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Boca Raton, FL
  • NPI 1710647334
  Medicare reassignment Care Compare group NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Melbourne, FL
  • NPI 1245472661
  NPD
• OB Hospitalist Group LLC

  • Obstetrics & Gynecology Physician
  • Winter Haven, FL
  • NPI 1851282016
  NPD
• Seth J Herbst MD PA

  • Obstetrics & Gynecology Physician
  • Wellington, FL
  • NPI 1871541052
  NPD (past)
• Women's Health Affiliates, Inc.

  dba Signature Healthcare Women's Health Affiliates

  • Obstetrics & Gynecology Physician
  • Brockton, MA
  • NPI 1396783742
  NPD (past)

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

• Boca Raton Regional Hospital, Inc.

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1902826779
  Care Compare affiliation

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1609857549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 ROYAL PALM BLVD",
            "address_2": "STE 108",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655795",
            "telephone_number": "954-341-8288",
            "fax_number": "954-341-5156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 ROYAL PALM BLVD",
            "address_2": "STE 108",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655795",
            "telephone_number": "954-341-8288",
            "fax_number": "954-341-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "TIM",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME93795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "53106",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273922400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Publix Super Markets Inc (Publix Pharmacy #1114)
• Publix Super Markets Inc (Publix Pharmacy #0549)
• Publix Super Markets Inc (Publix Pharmacy #0678)
• Publix Super Markets, Inc (Publix Pharmacy #1719)
• Publix Super Markets, Inc. (Publix Pharmacy #1834)
• Bincy Pulimootil, NP
• Pulmonary & Sleep Disorder Centers, Inc.
• Ameeta Pundit
• David A Pyner, D.D.S.
• Sofian Qamar, PHARM D

• Obstetrics & Gynecology Physician in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.