Individual provider Active NPI

Timothy Jay Panek, MD

  • Orthopaedic Surgery Physician
  • Oak Park Heights, MN
National Provider Identifier
1699771386
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
40589 Issued in MN
Practice address
5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone
(651) 439-8807
Fax
(651) 439-0232
NPI assigned
Jun 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 40589 MN Primary
Orthopaedic Surgery Physician 207X00000X 43367 WI

Addresses

Primary practice location

5803 Neal Ave N
Oak Park Heights, MN 55082-2177

Mailing address

5803 Neal Ave N
Oak Park Heights, MN 55082-2177
Phone (651) 439-8807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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
I20100119000106 MN Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8325952419 Reassigns benefits to 1 organization
I20100519000549 WI Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 8325952419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
University of Minnesota Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

4040 Radio Dr
Woodbury, MN 55129-3237
Phone (651) 439-8807

5715 Memorial Ave N
Oak Park Heights, MN 55082-1093
Phone (651) 439-8807

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement48
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43367WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA Orthopaedic Surgery CurrentSince Jul 1, 2015 Accepting new patients
Infinite Health Collaborative, PA Orthopaedic Surgery CurrentSince Jul 1, 2015 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients

Locations

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

310 Smith Ave N
Ste 330
Saint Paul, MN 55102
Phone (651) 227-6351

1701 Curve Crest Blvd W
Ste 104
Stillwater, MN 55082
Phone (651) 342-1883

5715 Memorial Ave N
Stillwater, MN 55082
Phone (514) 398-8076

3545 Highway 61 N
Vadnais Heights, MN 55110

4040 Radio Dr
Ste 200
Woodbury, MN 55129

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

411 Stageline Rd
#100
Hudson, WI 54016

2211 Vine St
Hudson, WI 54016
Phone (715) 386-1155

411 Stageline Rd
Ste 100
Hudson, WI 54016

Interoperability endpoints

  • Direct secure messaging: timothypanek@tw.allscriptsdirect.net

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 and National Provider Directory roles.

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1699771386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5803 NEAL AVE N",
            "city": "OAK PARK HEIGHTS",
            "state": "MN",
            "postal_code": "550822177",
            "telephone_number": "651-439-8807",
            "fax_number": "651-439-0232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANEK",
        "first_name": "TIMOTHY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "40589",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "43367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park Heights, MN

Sources for this page

Verify at the official NPI Registry.