Active NPI
Timothy Clayton Anton Acheson
- Physician Assistant
- Playa Vista, CA
National Provider Identifier
1801507694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA68274
- Practice address
- 12665 Village LN Apt 4505
Playa Vista, CA 90094-2863 - Phone
- (619) 507-2085
- NPI assigned
- Dec 12, 2022
- Last updated
- Aug 19, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA68274 | CA | Primary |
Addresses
Primary practice location
12665 Village LN Apt 4505
Playa Vista, CA 90094-2863
Mailing address
12665 Village LN Apt 4505
Playa Vista, CA 90094-2863
Phone (619) 507-2085
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787097600000",
"number": "1801507694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12665 VILLAGE LN APT 4505",
"city": "PLAYA VISTA",
"state": "CA",
"postal_code": "900942863",
"telephone_number": "619-507-2085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12665 VILLAGE LN APT 4505",
"city": "PLAYA VISTA",
"state": "CA",
"postal_code": "900942863",
"telephone_number": "619-507-2085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACHESON",
"first_name": "TIMOTHY",
"middle_name": "CLAYTON ANTON",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-12-12",
"last_updated": "2026-08-19",
"certification_date": "2026-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA68274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Playa Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.