Tim Bombard

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

002775 Issued in CT

Practice address

843 Main St # 15
Manchester, CT 06040-6020

Phone

(860) 648-3001

Fax

(860) 648-3003

NPI assigned

Jul 11, 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

Medicare fee-for-service enrollment

Enrolled in CT, MA2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4

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.

• Day Kimball Medical Group Inc

  • Family Medicine Physician
  • Putnam, CT
  • NPI 1376813972
  Medicare reassignment NPD
• Nes Medical Services of Northern Connecticut, P.C.

  • Emergency Medicine Physician
  • Putnam, CT
  • NPI 1447231865
  Medicare reassignment NPD
• Lakes/National Emergency Physicians Inc

  • Emergency Medicine Physician
  • Holyoke, MA
  • NPI 1114426772
  Medicare reassignment NPD
• Breakaway Health Services LLC

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1528777505
  NPD Authorized official
• Nes Medical Services of Northern Connecticut, P.C.

  • Emergency Medicine Physician
  • Stafford Springs, CT
  • NPI 1194450478
  NPD
• Anna Gut LLC

  • Psychiatric/Mental Health Registered Nurse
  • Rocky Hill, CT
  • NPI 1174949572
  NPD (past)
• Emergency Medicine of Florida, Inc.

  • Occupational Medicine Clinic/Center
  • Tampa, FL
  • NPI 1134235872
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1669470993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 PALISADO AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952037",
            "telephone_number": "860-214-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 MAIN ST # 15",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406020",
            "telephone_number": "860-648-3001",
            "fax_number": "860-648-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBARD",
        "first_name": "TIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "002775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andreas John Bojko, M.D.
• Amaria D Boland
• Christina Marie Bolduc Falzone, APRN FNP-C
• Natasha Bolorin
• Aimee Bombara, OTR/L
• Reva Bommer
• Jamie L Bonafine
• Steven Bonanno, PSY.D.
• Michael Robert Bond, D.M.D.
• Brian Bonds

• Family Nurse Practitioner in Manchester, CT
• Providers in Manchester, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.