Timothy Paul Landry, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L6526 Issued in OR

Practice address

1450 Birch Ave
Cottage Grove, OR 97424-1417

Phone

(503) 347-0003

NPI assigned

Jan 29, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Medical Group Cottage GroveGroup PAC ID 9436060530, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Cottage Grove Community Medical Center Hospital, Cottage Grove, OR, CCN 381301

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

96.74

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Peacehealth Medical Group Cottage Grove

  • Multi-Specialty Clinic/Center
  • Creswell, OR
  • NPI 1780631267
  Medicare reassignment Care Compare group NPD
• Peacehealth

  • Critical Access Hospital
  • Cottage Grove, OR
  • NPI 1902892391
  Medicare reassignment NPD
• Peacehealth Medical Group

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1447207287

  Mental Health

  Medicare reassignment NPD
• Tim Landry Therapy LLC

  • Adult Mental Health Clinic/Center
  • Cottage Grove, OR
  • NPI 1508789728
  NPD (past) Authorized official
• Peacehealth Medical Group

  • Birthing Clinic/Center
  • Springfield, OR
  • NPI 1881860856
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  • Critical Access Hospital
  • Cottage Grove, OR
  • NPI 1902892391
  Care Compare affiliation

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1700340270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974240010",
            "telephone_number": "503-347-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BIRCH AVE",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241417",
            "telephone_number": "503-347-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L6526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "101YM0800X",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yulia Kotlyar
• Daniel Kranitz, DO
• L Brent Bitner DDS PC
• Melissa Ladd, EPDH
• Lamplight Therapy LLC
• Lane Emergency Physicians, LLC
• Sydelle Lang
• Jean Langkow, ANP
• Melissa Lanham, L.M.T.
• Andres Larios

• Mental Health Counselor in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.