Individual provider Active NPI

Timothy Ivan Alves, M.D.

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1720379910
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301100182 Issued in MI
Practice address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone
(616) 363-7272
Fax
(616) 361-5828
NPI assigned
Apr 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 4301100182 MI Primary

Addresses

Primary practice location

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA, MA, NH4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20160712001093 MI Practitioner - Diagnostic Radiology 2860794955
I20201224000179 CA Practitioner - Diagnostic Radiology 2860794955 Reassigns benefits to 1 organization
I20240117001455 MA Practitioner - Diagnostic Radiology 2860794955 Reassigns benefits to 1 organization
I20240117001690 NH Practitioner - Diagnostic Radiology 2860794955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Carolina at Chapel Hill School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909

217 Jubilee St
Lodi, CA 95242-9712
Phone (978) 354-4181

30 Tuscan Blvd
Salem, NH 03079-3981
Phone (857) 282-8100

480 Lynnfield St
Lynn, MA 01904-1419
Phone (781) 342-4386

789 Central Ave
Dover, NH 03820-2526
Phone (603) 740-2250

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301100182MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
General Hospital Corp Current Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Mar 1, 2024 Accepting new patients

Locations

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

399 Revolution Dr
Ste 1010
Somerville, MA 02145
Phone (857) 282-2063

30 Tuscan Blvd
Salem, NH 03079
Phone (857) 282-8100

Interoperability endpoints

  • Direct secure messaging: alves.timothy.mgh@direct.partners.masshiway.net
  • Direct secure messaging: talves136937@direct.covenanthealthcare.com

Organizations & group practices 2

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 7

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": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1720379910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVES",
        "first_name": "TIMOTHY",
        "middle_name": "IVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-22",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301100182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.