Individual provider Active NPI

Timothy Jacque Flaugher, PA-C

  • Physician Assistant
  • Hudson, FL
National Provider Identifier
1801878970
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9109293 Issued in FL
Practice address
14000 Fivay Rd
Hudson, FL 34667-7103
Phone
(727) 869-5583
NPI assigned
Nov 15, 2005
Last updated
Nov 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9109293 FL Primary

Addresses

Primary practice location

14000 Fivay Rd
Hudson, FL 34667-7103

Mailing address

14249 Cascora CT
Spring Hill, FL 34609-0864
Phone (813) 389-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080920000129 FL Practitioner - Physician Assistant 9638119035 Reassigns benefits to 1 organization
I20230405000251 VA Practitioner - Physician Assistant 9638119035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9109293FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Mar 1, 2023 Accepting new patients
Riverside Physician Services Inc CurrentSince Mar 1, 2023 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1801878970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14249 CASCORA CT",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346090864",
            "telephone_number": "813-389-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-869-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAUGHER",
        "first_name": "TIMOTHY",
        "middle_name": "JACQUE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9109293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.