NPIMap

Individual provider Active NPI

Timothy James Muhonen, MD

  • Family Medicine Physician
  • Mountain Home, ID
National Provider Identifier
1780752469
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD186714 Issued in OR
Practice address
465 McKenna Dr
Mountain Home, ID 83647
Phone
(208) 587-9703
NPI assigned
Dec 1, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00043473 WA
Family Medicine Physician 207Q00000X NM2007-0097 NM
Family Medicine Physician 207Q00000X 40961 CO
Family Medicine Physician 207Q00000X MD186714 OR Primary
Family Medicine Physician 207Q00000X M-11354 ID

Addresses

Primary practice location

465 McKenna Dr
Mountain Home, ID 83647

Mailing address

495 E 17TH N
Mountain Home, ID 83647-1757
Phone (505) 801-6577

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmuhonen958100@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20180712002517 OR Practitioner - Family Practice 3971586512 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1332 S Shasta Ave
Suite a
Eagle Point, OR 97524-8623
Phone (541) 826-8160

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions36
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40961COMDFamily Medicine Physician
M-11354IDMDFamily Medicine Physician
NM2007-0097NMMDFamily Medicine Physician
MD186714ORMDFamily Medicine Physician
MD00043473WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Aug 31, 2018 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Aug 31, 2018 Accepting new patients
Providence Health & Services Oregon Family Medicine CurrentSince Aug 31, 2018 Accepting new patients
Providence Health & Services Oregon Family Medicine Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 31, 2018 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Elmore Medical Center Hospital District Family Medicine Past Accepting new patients

Locations

1332 S Shasta Ave
Ste A
Eagle Point, OR 97524
Phone (541) 732-5720

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

Interoperability endpoints

  • Direct secure messaging: tmuhonen958100@oc.providencedirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1780752469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 E 17TH N",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836471757",
            "telephone_number": "505-801-6577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MCKENNA DR",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "83647",
            "telephone_number": "208-587-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHONEN",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00043473",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "NM2007-0097",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "40961",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD186714",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-11354",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmuhonen958100@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1332 S Shasta Ave Ste A",
            "city": "Eagle Point",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975248623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mountain Home, ID

Sources for this page

Verify at the official NPI Registry.