Agnes Timberger, LISCENSED MASTER SOC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089546-01 Issued in NY

Practice address

626 Eatontown Road
Port Jervis, NY 12771

Phone

(845) 978-7979

Fax

(845) 355-7929

NPI assigned

Dec 5, 2013

Last updated

Apr 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Agnes Montalvo Timberger Professional name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: agnestimberger@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1659702363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330",
            "city": "SLATE HILL",
            "state": "NY",
            "postal_code": "109730330",
            "telephone_number": "845-978-7979",
            "fax_number": "845-355-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 EATONTOWN ROAD",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "12771",
            "telephone_number": "845-978-7979",
            "fax_number": "845-355-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMBERGER",
        "first_name": "AGNES",
        "credential": "LISCENSED MASTER SOC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "039221-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089546-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "MONTALVO TIMBERGER",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Avion J Thomas-Walsh, FNP
• Gincy Thomas, PT
• Thompson Town Dental PLLC (Port Jervis Smiles)
• Martha McPhail Thomson, NP
• Eugenia Marie Tice-Shepard, PT,DPT
• Muhlise Dide Tosyali, D.M.D.
• Tri-State Emergency Physicians PLLC
• Tri-State Radiology, P.C.
• Lacey Anne Trimble, LCSW
• Jenna Trone

• Clinical Social Worker in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.