Individual provider Active NPI

Timothy Ronald Mason

  • Physical Medicine & Rehabilitation Physician
  • Wheaton, IL
National Provider Identifier
1801590849
Registry record updated Jun 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
125.081273 Issued in IL
Practice address
26W171 Roosevelt Rd
Wheaton, IL 60187-6002
Phone
(708) 783-9100
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.081273 IL
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 125.081273 IL
Physical Medicine & Rehabilitation Physician 208100000X 125.081273 IL Primary

Addresses

Primary practice location

26W171 Roosevelt Rd
Wheaton, IL 60187-6002

Mailing address

26W171 Roosevelt Rd
Wheaton, IL 60187-6002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230830001062 IL Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Internal MedicinePractitioner - Physical Medicine and Rehabilitation 5496118093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.081273ILMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1801590849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26W171 ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26W171 ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601876002",
            "telephone_number": "708-783-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "TIMOTHY",
        "middle_name": "RONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.081273",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "125.081273",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "125.081273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.