NPIMap

Individual provider Active NPI

Timothy G Cook, M.D.

  • Family Medicine Physician
  • Granville, NY
National Provider Identifier
1720071095
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
320347 Issued in NY
Practice address
79 North St
Granville, NY 12832-1137
Phone
(518) 642-0612
Fax
(518) 642-0693
NPI assigned
Aug 23, 2005
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 320347 NY Primary
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

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address timothy.cook@cdirectglensfallshosp.org
Direct Messaging Address timothy.cook@cdirectglensfallshosp.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040715000719 VT Practitioner - Family Practice 3072592856 Practice locations: Rutland, VT
I20230103000840 NY Practitioner - Family Practice 3072592856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 8325955974, 175 clinicians

Practice addresses (Care Compare)

35 Gilbert St
Cambridge, NY 12816-2618
Phone (518) 677-3961

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
320347NYMDLicensed Practical Nurse
042-0009268VTMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Glens Falls Hospital Inc. Family Medicine CurrentSince Jan 5, 2023 Accepting new patients
Glens Falls Hospital Inc CurrentSince Jan 5, 2023 Accepting new patients
Clearchoicemd Primary Care PLLC Family Medicine Past Accepting new patients
Convenient Medical Care Family Medicine PastSince Jan 1, 1990 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

  • FHIR API: https://api.platform.athenahealth.com/19910/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tcook97770@albanymed.direct-ci.com
  • Direct secure messaging: timothy.cook@cdirectglensfallshosp.org

Organizations & group practices 4

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1720071095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PARK STREET",
            "address_2": "GLENS FALLS HOSPITAL - CREDENTIALING",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014413",
            "telephone_number": "518-926-6992",
            "fax_number": "802-775-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 NORTH ST",
            "city": "GRANVILLE",
            "state": "NY",
            "postal_code": "128321137",
            "telephone_number": "518-642-0612",
            "fax_number": "518-642-0693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Gilbert Street",
            "address_2": "Cambridge Medical Center",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "NY",
            "postal_code": "128162618",
            "country_code": "US",
            "telephone_number": "518-677-3961",
            "fax_number": "518-677-3180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "TIMOTHY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "320347",
            "primary": true
        },
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "VT",
            "license": "042-0009268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.cook@cdirectglensfallshosp.org",
            "affiliation": "N",
            "address_1": "79 North St",
            "city": "Granville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128321137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.cook@cdirectglensfallshosp.org",
            "affiliation": "N",
            "address_1": "35 Gilbert Street",
            "address_2": "Cambridge Medical Center",
            "city": "Cambridge",
            "state": "NY",
            "country_code": "US",
            "postal_code": "128162618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Granville, NY

Sources for this page

Verify at the official NPI Registry.