Active NPI
Mary Roz Timbang, M.D.
- Pediatric Otolaryngology Physician
- Little Rock, AR
National Provider Identifier
1760877922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Otolaryngology Physician
- License
- E-14382
- Practice address
- 1 Childrens Way # 653
Little Rock, AR 72202-3500 - Phone
- (501) 364-1100
- NPI assigned
- Apr 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | E-14382 | AR | |
| Plastic Surgery within the Head & Neck (Otolaryngology) Physician | 207YX0007X | E-14382 | AR | |
| Pediatric Otolaryngology Physician | 207YP0228X | E-14382 | AR | Primary |
Addresses
Primary practice location
1 Childrens Way # 653
Little Rock, AR 72202-3500
Mailing address
PO Box 251418
Little Rock, AR 72225-1418
Phone (501) 364-1100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-8408
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-14382 | AR | MD | Pediatric Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Los Angeles Medical Group, Inc. | Current | Accepting new patients | |
| Childrens Hospital of Los Angeles | Past | Accepting new patients |
Locations
4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122
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.
-
- Multi-Specialty Clinic/Center
- Los Angeles, CA
- NPI 1265530653
-
- Children's Hospital
- Los Angeles, CA
- NPI 1124073366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646352000000",
"number": "1760877922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 251418",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722251418",
"telephone_number": "501-364-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS WAY # 653",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMBANG",
"first_name": "MARY ROZ",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-03",
"last_updated": "2022-03-04",
"certification_date": "2022-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "AR",
"license": "E-14382",
"primary": false
},
{
"code": "207YX0007X",
"taxonomy_group": "",
"desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
"state": "AR",
"license": "E-14382",
"primary": false
},
{
"code": "207YP0228X",
"taxonomy_group": "",
"desc": "Otolaryngology, Pediatric Otolaryngology",
"state": "AR",
"license": "E-14382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.