NPIMap

Individual provider Active NPI

Timothy Bouck, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Winchester, VA
National Provider Identifier
1669586152
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
0101248936 Issued in VA
Practice address
1840 Amherst St
Winchester, VA 22601-2808
Phone
(540) 536-7087
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101248936 VA Primary

Addresses

Primary practice location

1840 Amherst St
Winchester, VA 22601-2808

Mailing address

2531 Goldenfield LN
Winchester, VA 22601-6433
Phone (804) 564-6036

Other identifiers 2

IdentifierTypeStateIssuer
1669586152MedicaidVA
3810019813MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbouck124445@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110908002020 VA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 4486824000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
University of Virginia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winchester Medical CenterGroup PAC ID 0244134021, 313 clinicians

Practice addresses (Care Compare)

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8700

1880 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-6721

Hospital & facility affiliations

  • Winchester Medical Center Hospital, Winchester, VA, CCN 490005
  • Page Memorial Hospital, Inc Hospital, Luray, VA, CCN 491307
  • Warren Memorial Hospital Hospital, Front Royal, VA, CCN 490033

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
83.98
Improvement activities
40
Cost
76.51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Jul 18, 2011 Accepting new patients
Winchester Medical Center Critical Care Medicine CurrentSince Jul 18, 2011 Accepting new patients
Winchester Medical Center Past Accepting new patients

Locations

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Interoperability endpoints

  • Direct secure messaging: tbouck124445@valleyhealth.direct-ci.com

Organizations & group practices 11

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1669586152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2531 GOLDENFIELD LN",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016433",
            "telephone_number": "804-564-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012808",
            "telephone_number": "540-536-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCK",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101248936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669586152",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810019813",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbouck124445@soc.inova.org",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.