Beverly Timothy

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

302799 Issued in NY

Practice address

9704 Sutphin Blvd
Jamaica, NY 11435-4721

Phone

(718) 657-7088

Fax

(718) 657-7092

NPI assigned

Feb 2, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

State University of New York at Stony Brook, School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Modern Physician Services PCGroup PAC ID 6204140544, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHFABD

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.

• Modern Physician Services PC

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1932590601
  Medicare reassignment Care Compare group NPD
• Aliviane, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • El Paso, TX
  • NPI 1356557425
  NPD (past)

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1649502568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 COLONIAL AVE",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9704 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114354721",
            "telephone_number": "718-657-7088",
            "fax_number": "718-657-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMOTHY",
        "first_name": "BEVERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "302799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliet Thorpe, RN
• Sujitha Nicholas Thottam, ANP/GNP
• Three Generations Medical PC
• Craig Thurm, MD
• Gabriella P Thybulle
• Elizabeth Tinagero, MA, CCC-SLP
• Dorene Tindal, PTA
• Avtar Singh Tinna, D.D.S.
• Audrey Michele Tinsley, PA
• Melanie Tinsley

• Adult Health Nurse Practitioner in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.