Timothy J Mahoney, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

3622 Issued in ND

Practice address

1707 Gold Dr S Ste 101
Fargo, ND 58103-6413

Phone

(701) 280-2033

Fax

(701) 232-5578

NPI assigned

Jul 10, 2006

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in ND, MN2 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

Specialty

General SurgeryAlso: Family Practice

Education

Tufts University School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Vein Clinics PCGroup PAC ID 9638356876, 7 clinicians

Family Health Care CenterGroup PAC ID 1658283650, 25 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/
• Direct secure messaging: timothy.mahoney.1@28859.direct.athenahealth.com

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.

• Family Health Care Center

  • Federally Qualified Health Center (FQHC)
  • Fargo, ND
  • NPI 1710066352
  Medicare reassignment Care Compare group NPD
• Physicians Vein Clinics, PC

  • Phlebology Physician
  • Sioux Falls, SD
  • NPI 1720370133

  Family Medicine, ND

  Medicare reassignment Care Compare group NPD
• Internal Medicine Associates Inc

  • Internal Medicine Physician
  • Fargo, ND
  • NPI 1144313743
  Medicare reassignment NPD
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Critical Access Hospital
  • Elbow Lake, MN
  • NPI 1407838329
  Medicare reassignment NPD
• Family Health Care Center

  dba Family HealthCare

  • Federally Qualified Health Center (FQHC)
  • Moorhead, MN
  • NPI 1992559645
  NPD
• Lake Region Healthcare Corporation

  • General Acute Care Hospital
  • Fergus Falls, MN
  • NPI 1093713372
  NPD
• Lake Region Healthcare Corporation

  • Chiropractor
  • Fergus Falls, MN
  • NPI 1265148480
  NPD
• Lake Region Healthcare Corporation

  dba Lake Region Healthcare

  • Durable Medical Equipment & Medical Supplies
  • Fergus Falls, MN
  • NPI 1942191119
  NPD
• Dakota Clinic, LTD.

  dba Dakota Clinic, LTD. - Independent Lab

  • Clinical Medical Laboratory
  • Fargo, ND
  • NPI 1740220391
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1689608192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 GOLD DR S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036413",
            "telephone_number": "701-280-2033",
            "fax_number": "701-232-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 GOLD DR S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036413",
            "telephone_number": "701-280-2033",
            "fax_number": "701-232-5578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Np Ave N",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581024835",
            "country_code": "US",
            "telephone_number": "701-271-3344",
            "fax_number": "701-271-3347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "3622",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "24007",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ND",
            "license": "3622",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "3622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nalina Maharaj-Pearson
• Arslan Mahmood, MD
• Ali Mohamed Mahmoud
• Susan M Mahoney-Weber, PHARMD RPH
• Julia Britt Mahoney, APRN
• Samantha Maier
• Kuvan Maii
• Main St RX LLC
• Chetan P Maingi, MD
• Beth A Mairs, OTR/L

• Surgery Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.