Individual provider Active NPI

Timothy J Beatty, O.D.

  • Optometrist
  • Connersville, IN
National Provider Identifier
1619954294
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003060A Issued in IN
Practice address
2045 Virginia Ave
Connersville, IN 47331-2921
Phone
(765) 825-0660
Fax
(765) 825-3075
NPI assigned
Dec 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003060A IN Primary

Addresses

Primary practice location

2045 Virginia Ave
Connersville, IN 47331-2921

Mailing address

PO Box 399
Richmond, IN 47375-0399
Phone (765) 962-2020

Other identifiers 1

IdentifierTypeStateIssuer
200289100MedicaidIN

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040513000899 IN Practitioner - Optometry 9830189752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitewater Eye Centers LLCGroup PAC ID 6608914072, 13 clinicians

Practice addresses (Care Compare)

1900 Chester Blvd
Richmond, IN 47374-1213
Phone (765) 962-2020

Merit-based Incentive Payment System (MIPS)

Final score
83.19 of 100Reported as group
Quality
96.18
Improvement activities
40
Cost
49.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Whitewater Eye Centers LLC Optometrist CurrentSince Nov 1, 2009 Accepting new patients
Whitewater Eye Centers LLC Optometrist Current Accepting new patients
Whitewater Eye Centers LLC Optometrist CurrentSince Nov 1, 2009 Accepting new patients

Locations

2045 Virginia Ave
Connersville, IN 47331
Phone (765) 825-0660

1900 Chester Blvd
Richmond, IN 47374
Phone (765) 962-2020

Interoperability endpoints

  • Direct secure messaging: tbeatty@whitewater.intellechartdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286928000000",
    "number": "1619954294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 399",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473750399",
            "telephone_number": "765-962-2020",
            "fax_number": "765-966-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312921",
            "telephone_number": "765-825-0660",
            "fax_number": "765-825-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2010-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003060A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200289100",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Connersville, IN

Sources for this page

Verify at the official NPI Registry.