NPIMap

Individual provider Active NPI

Timothy Robert Killeen, M.D.

  • Pulmonary Disease Physician
  • Louisville, KY
National Provider Identifier
1730187790
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
25892 Issued in KY
Practice address
4606 Greenwood Rd
Louisville, KY 40258
Phone
(502) 937-2209
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 25892 KY Primary

Addresses

Primary practice location

4606 Greenwood Rd
Louisville, KY 40258

Mailing address

PO Box 776351 Suite 305
Chicago, IL 60677-6351

Other practice location 1

4402 Churchman Ave
Suite 305
Louisville, KY 40215-1190
Phone (502) 368-9590

Other practice location 2

4402 Churchman Ave
Suite 305
Louisville, KY 40215-1190
Phone (502) 368-9590

Other identifiers 8

IdentifierTypeStateIssuer
64258924MedicaidKY
K307890OtherKYMEDICARE PTAN
021102300OtherFEDERAL BLACK LUNG
2432232000OtherPASSPORT ADVANTAGE
200240660AMedicaidIN
000000047638OtherANTHEM
1048815OtherPASSPORT
611001258OtherHUMANA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tkilleen160727@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090305000361 KY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 8628970670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Virginia Commonwealth University, School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4606 Greenwood Rd
Louisville, KY 40258-3726
Phone (502) 937-2209

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • Norton Clark Hospital Hospital, Jeffersonville, IN, CCN 150009
  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Louisville & So Indiana Pulmonary Care Past Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

3430 Newburg Rd
Ste 150
Louisville, KY 40218
Phone (502) 459-9127

676 S Floyd St
Ste 200
Louisville, KY 40202
Phone (502) 629-2500

4606 Greenwood Rd
Louisville, KY 40258
Phone (502) 937-2209

170 Dr Arla Way
Ste 10
Louisville, KY 40229
Phone (502) 559-5864

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

100 W Market St
Ste 2
Louisville, KY 40202

300 High Point Ct
Mt Washington, KY 40047
Phone (502) 447-4595

Organizations & group practices 5

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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1730187790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351 SUITE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 GREENWOOD RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40258",
            "telephone_number": "502-937-2209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4402 Churchman Ave",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402151190",
            "country_code": "US",
            "telephone_number": "502-368-9590",
            "fax_number": "502-368-9616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4402 Churchman Ave",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402151190",
            "country_code": "US",
            "telephone_number": "502-368-9590",
            "fax_number": "502-368-9616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLEEN",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "KY",
            "license": "25892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64258924",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K307890",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "021102300",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2432232000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200240660A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000047638",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1048815",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "611001258",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkilleen160727@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "4606 Greenwood Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4606 Greenwood Rd",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.