NPIMap

Individual provider Active NPI

Timothy John Vanderkwaak, M.D.

  • Gynecologic Oncology Physician
  • Sylva, NC
National Provider Identifier
1699734863
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
200000648 Issued in NC
Practice address
609 Asheville Hwy
Sylva, NC 28779-2747
Phone
(828) 586-7697
NPI assigned
Mar 17, 2006
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2000-00648 NC
Gynecologic Oncology Physician 207VX0201X 200000648 NC Primary

Addresses

Primary practice location

609 Asheville Hwy
Sylva, NC 28779-2747

Mailing address

PO Box 16948
Asheville, NC 28816-0948
Phone (828) 670-8403

Other practice location 1

100 Ridgefield Ct
Asheville, NC 28806-2270
Phone (828) 670-8403

Other identifiers 2

IdentifierTypeStateIssuer
89126HCMedicaidNC
126HCOtherNCBLUE CROSS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothyvanderkwaakmd@Direct.msj.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100818001382 NC Practitioner - Gynecological OncologyPractitioner - Obstetrics/Gynecology 2769532621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gynecological OncologyAlso: Obstetrics/Gynecology
Education
Wayne State University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-2325

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000-00648NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Health Community Multispecialty Providers, LLC Current Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Dec 1, 2018 Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Dec 1, 2018 Accepting new patients
Hope a Womens Cancer Center, PA Gynecologic Oncology Current Accepting new patients
Mission Community Anesthesiology Specialists LLC Past Accepting new patients

Locations

100 Ridgefield Ct
Asheville, NC 28806
Phone (828) 670-8403

100 Ridgefield Ct
Ste A
Asheville, NC 28806
Phone (828) 670-5665

428 Biltmore Ave
#4S
Asheville, NC 28801

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

609 Asheville Hwy
Sylva, NC 28779
Phone (828) 213-4830

6 Sheridan Sq
Ste 100
Kingsport, TN 37660
Phone (423) 228-0163

Interoperability endpoints

  • Direct secure messaging: timothyvanderkwaakmd@direct.msj.org

Organizations & group practices 5

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 11

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1699734863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16948",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288160948",
            "telephone_number": "828-670-8403",
            "fax_number": "828-670-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 ASHEVILLE HWY",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287792747",
            "telephone_number": "828-586-7697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Ridgefield Ct",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288062270",
            "country_code": "US",
            "telephone_number": "828-670-8403",
            "fax_number": "828-670-8404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERKWAAK",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2000-00648",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NC",
            "license": "200000648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126HC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "126HC",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothyvanderkwaakmd@Direct.msj.org",
            "affiliation": "N",
            "address_1": "100 Ridgefield Ct",
            "city": "Asheville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "288062270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

Verify at the official NPI Registry.