Individual provider Active NPI

Timothy Breitholtz, M.D.

  • Psychiatry Physician
  • Concord, NH
National Provider Identifier
1679646467
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
265107 Issued in MA
Practice address
10 West St
Concord, NH 03301-3548
Phone
(603) 225-0123
Fax
(508) 790-3304
NPI assigned
Nov 17, 2006
Last updated
Jan 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 8509 NH
Psychiatry Physician 2084P0800X 265107 MA Primary

Addresses

Primary practice location

10 West St
Concord, NH 03301-3548

Mailing address

PO Box 2032
Concord, NH 03302-2032
Phone (603) 225-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051105000045 NH Practitioner - Psychiatry 1759309099 Reassigns benefits to 1 organization
I20160107002920 MA Practitioner - Psychiatry 1759309099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 228-7200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265107MAMDPsychiatry Physician
8509NHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of Cape Cod Hospital CurrentSince Oct 30, 2017 Accepting new patients
Riverbend Community Mental Health, Inc. CurrentSince Dec 7, 2022 Accepting new patients
Seacoast Mental Health Center, Inc. Past Accepting new patients

Locations

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

10 West St
Concord, NH 03301
Phone (603) 225-0123

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

29 School St
Concord, NH 03301
Phone (603) 228-1600

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1679646467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2032",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033022032",
            "telephone_number": "603-225-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WEST ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013548",
            "telephone_number": "603-225-0123",
            "fax_number": "508-790-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITHOLTZ",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "8509",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "265107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.