Individual provider Active NPI

Timothy James Ferguson, PA-C

  • Medical Physician Assistant
  • Middletown, NY
National Provider Identifier
1750890901
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
021345 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940-2650
Phone
(845) 333-7575
Fax
(845) 333-7202
NPI assigned
Sep 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 021345 NY
Medical Physician Assistant 363AM0700X 021345 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940-2650

Mailing address

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

Other practice location 1

102 Clowes Ave
Goshen, NY 10924-1956
Phone (845) 333-7200

Other practice location 2

38 Concord Rd
Monticello, NY 12701-3210
Phone (845) 333-6500

Other practice location 3

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

Other practice location 4

68 Harris Bushville Rd
Harris, NY 12742
Phone (845) 333-8909

Other practice location 5

475 Seaview Ave
Staten Island, NY 10305-3436
Phone (718) 226-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tferguson58855@direct.garnethealth.org Direct Garnet Health Doctors PC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171128002558 NY Practitioner - Physician Assistant 8325305451 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Garnet Health Doctors PCGroup PAC ID 8628293545, 165 clinicians

Practice addresses (Care Compare)

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-7575

Hospital & facility affiliations

  • Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126
  • Garnet Health Medical Center Catskills Hospital, Harris, NY, CCN 330386
  • Westchester Medical Center Hospital, Valhalla, NY, CCN 330234
  • Ellenville Regional Hospital Hospital, Ellenville, NY, CCN 331310

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
61
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Apr 1, 2019 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: tferguson58855@direct.garnethealth.org

Organizations & group practices 7

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 5

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": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1750890901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575",
            "fax_number": "845-333-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109402650",
            "telephone_number": "845-333-7575",
            "fax_number": "845-333-7202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Clowes Ave",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "NY",
            "postal_code": "109241956",
            "country_code": "US",
            "telephone_number": "845-333-7200",
            "fax_number": "845-333-7208",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38 Concord Rd",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "NY",
            "postal_code": "127013210",
            "country_code": "US",
            "telephone_number": "845-333-6500",
            "fax_number": "845-333-6501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "707 E Main St",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109402650",
            "country_code": "US",
            "telephone_number": "845-333-7575",
            "fax_number": "845-333-7139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 Harris Bushville Rd",
            "address_purpose": "LOCATION",
            "city": "Harris",
            "state": "NY",
            "postal_code": "12742",
            "country_code": "US",
            "telephone_number": "845-333-8909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "475 Seaview Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103053436",
            "country_code": "US",
            "telephone_number": "718-226-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-04-08",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021345",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "021345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tferguson58855@direct.garnethealth.org",
            "affiliation": "Y",
            "affiliationName": "Garnet Health Doctors PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "707 E Main St",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109402650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.