Individual provider Active NPI

Timothy K Putty, MD

  • Neurological Surgery Physician
  • Tucson, AZ
National Provider Identifier
1679568869
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
20640 Issued in AZ
Practice address
5860 N la Cholla Blvd
#100
Tucson, AZ 85741-3596
Phone
(520) 742-7890
Fax
(520) 742-7894
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 20640 AZ Primary

Addresses

Primary practice location

5860 N la Cholla Blvd
#100
Tucson, AZ 85741-3596

Mailing address

5860 N la Cholla Blvd
#100
Tucson, AZ 85741-3596
Phone (520) 742-7890

Other identifiers 1

IdentifierTypeStateIssuer
100983MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101118001129 AZ Practitioner - NeurosurgeryPractitioner - Neurology 1052507852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Indiana University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Medical NetworkGroup PAC ID 9638457013, 276 clinicians

Practice addresses (Care Compare)

5860 N la Cholla Blvd
Suite 100
Tucson, AZ 85741-3597
Phone (520) 420-2045

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Tucson, AZ, CCN 037451
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006
  • Northwest Medical Center Hospital, Tucson, AZ, CCN 030085
  • Oro Valley Hospital Hospital, Oro Valley, AZ, CCN 030114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion84
Laminectomy or laminotomy (partial removal of spine bones)109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20640AZMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Medical Network CurrentSince Mar 31, 2023 Accepting new patients
Kelso Neuromonitoring PLLC Current Accepting new patients

Locations

5300 E Erickson Dr
Ste 112
Tucson, AZ 85712

5860 N La Cholla Blvd
Ste 100
Tucson, AZ 85741
Phone (520) 420-2045

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

1845 W Orange Grove Rd
Ste 109
Tucson, AZ 85704
Phone (520) 797-9474

Organizations & group practices 2

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1679568869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 N LA CHOLLA BLVD",
            "address_2": "#100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413596",
            "telephone_number": "520-742-7890",
            "fax_number": "520-742-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 N LA CHOLLA BLVD",
            "address_2": "#100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413596",
            "telephone_number": "520-742-7890",
            "fax_number": "520-742-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTTY",
        "first_name": "TIMOTHY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "20640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100983",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.