Timothy G Cook, M.D.
Individual provider Active NPI Family Medicine Physician · Granville, NY
NPI 1720071095 · NPPES record last updated Jan 8, 2024
Key facts
- NPI
- 1720071095
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 320347 (NY)
- Practice address
- 79 North St
Granville, NY 12832-1137 - Phone
- (518) 642-0612
- Fax
- (518) 642-0693
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Glens Falls Hospital Inc
Practice addresses (Care Compare)
35 Gilbert St
Cambridge, NY 12816-2618
Phone (518) 677-3961
Hospital & facility affiliations
- HCR / HCR Home Care Chha (Plattsburgh)
- Eddy Visiting Nurse & Rehab Association
- High Peaks Hospice and Palliative Care, Inc
- Glens Falls Hospital
- Albany Medical Center Hospital
- Rutland Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040715000719 | VT | Practitioner - Family Practice | 3072592856 | Practice locations: Rutland, VT |
| I20230103000840 | NY | Practitioner - Family Practice | 3072592856 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 320347 | NY | MD | Licensed Practical Nurse |
| 042-0009268 | VT | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glens Falls Hospital Inc. | Family Medicine | Current |
Accepting new patients |
| Glens Falls Hospital Inc | Current |
Accepting new patients | |
| Convenient Medical Care | Family Medicine | Past |
Accepting new patients |
| Clearchoicemd Primary Care PLLC | Family Medicine | Past | Accepting new patients |
Locations
35 Gilbert St
Cambridge, NY 12816
Phone (518) 677-3163
100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924
79 North St
Granville, NY 12832
Phone (518) 642-0612
Interoperability endpoints
- tcook97770@albanymed.direct-ci.com
- https://api.platform.athenahealth.com/19910/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 320347 | NY | Yes |
| Legal Medicine | 173000000X | 042-0009268 | VT |
Addresses
Primary practice location
79 North St
Granville, NY 12832-1137
Mailing address
100 Park Street
Glens Falls Hospital - Credentialing
Glens Falls, NY 12801-4413
Phone (518) 926-6992
Other practice location 1
35 Gilbert Street
Cambridge Medical Center
Cambridge, NY 12816-2618
Phone (518) 677-3961
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 080177542 | Other | VT | RAILROAD MEDICARE |
| 49970 | Other | VT | BCBS VT |
| OVN2470 | Medicaid | VT | |
| 267562 | Other | VT | CIGNA |
| 08066 | Other | VT | MVP |
| 58435 | Other | VT | BCBS |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | timothy.cook@cdirectglensfallshosp.org | ||
| Direct Messaging Address | timothy.cook@cdirectglensfallshosp.org |
Other providers in Granville, NY
- Steven Benson
- Bianca B. Bernard
- Jennifer Blais
- CLR Granville LLC
- Harvey Samuel Coco
- April Lynn Cosey
- Michelle Karen Daigle
- W Marvin Day
- Laurie Ann Dennison
- Grace Nichole Deyoung
All providers in Granville, NY · Family Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.