Individual provider Active NPI

Timothy M Cotter, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1790769511
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-099889 Issued in IL
Practice address
1501 S California Ave
Chicago, IL 60608-1732
Phone
(773) 257-6498
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-099889 IL Primary

Addresses

Primary practice location

1501 S California Ave
Chicago, IL 60608-1732

Mailing address

3537 Paysphere Cir
Chicago, IL 60674-0035
Phone (708) 786-2900

Other identifiers 1

IdentifierTypeStateIssuer
036-099889-1MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MI, RI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20051020000182 IL Practitioner - Diagnostic Radiology 3476579368 Reassigns benefits to 3 organizations
I20131209000223 MI Practitioner - Diagnostic Radiology 3476579368 Reassigns benefits to 1 organization
I20170328000285 RI Practitioner - Diagnostic Radiology 3476579368 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-099889ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai Community Foundation Current Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince Jan 1, 2007 Accepting new patients
Mount Sinai Community Foundation CurrentSince Aug 19, 2005 Accepting new patients
Smi Imaging, LLC Diagnostic Radiology CurrentSince Jan 18, 2024 Accepting new patients
Howard Simon MD PLLC Diagnostic Radiology CurrentSince Sep 18, 2023 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Jan 1, 2007 Accepting new patients
Mount Sinai Community Foundation CurrentSince Aug 19, 2005 Accepting new patients
Basha Diagnostics P C Diagnostic Radiology CurrentSince Sep 3, 2013 Accepting new patients
Mediscan Imaging Center of Rockford LLC Diagnostic Radiology Past Accepting new patients
Illinois Bone and Joint Institute Past Accepting new patients
Pulmonary & Critical Care Medicine Specialists SC Past Accepting new patients
Germbusters, PC Past Accepting new patients

Locations

20414 N 27th Ave
Ste 150
Phoenix, AZ 85027
Phone (623) 234-2520

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

4849 W Fullerton Ave
Chicago, IL 60639
Phone (773) 237-2900

5057 Paysphere Cir
Chicago, IL 60674

1501 S California Ave
Chicago, IL 60608
Phone (773) 257-6770

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

3537 Paysphere Cir
Chicago, IL 60674

20530 N Rand Rd
Ste 350
Deer Park, IL 60010
Phone (847) 550-6740

1555 N Barrington Rd
Ste 235
Hoffman Estates, IL 60169
Phone (847) 843-7474

716 Florsheim Dr
Libertyville, IL 60048
Phone (847) 918-9077

9000 Waukegan Rd
Ste 110
Morton Grove, IL 60053
Phone (847) 213-2700

8930 Waukegan Rd
Ste 130
Morton Grove, IL 60053
Phone (847) 929-5453

30701 Woodward Ave
Ste Ll
Royal Oak, MI 48073
Phone (248) 288-1600

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1790769511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740035",
            "telephone_number": "708-786-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTER",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-099889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-099889-1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.