Individual provider Active NPI

Timothy J Hart, DPM

  • Podiatrist
  • Burrillville, RI
National Provider Identifier
1801988647
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPM00222 Issued in RI
Practice address
1376 Broncos Hwy Rte 102
Burrillville, RI 02858
Phone
(401) 568-9980
Fax
(401) 769-2125
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2162 MA
Podiatrist 213E00000X DPM00222 RI Primary

Addresses

Primary practice location

1376 Broncos Hwy Rte 102
Burrillville, RI 02858

Mailing address

301 Mendon Road
Woonsocket, RI 02895
Phone (401) 769-5011

Other identifiers 1

IdentifierTypeStateIssuer
TH00848MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080829000021 RI Practitioner - Podiatry 9335140748 Reassigns benefits to 2 organizations
I20120713000256 MA Practitioner - Podiatry 9335140748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1376 Bronco Hwy
Oakland, RI 02858-1000
Phone (401) 568-9980

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1028
Removal or shaving of skin growth111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2162MAMDAddiction (Substance Use Disorder) Counselor
222RIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Foot Care of Rhode Island PC Podiatrist CurrentSince Apr 1, 2022 Accepting new patients
Franklin Foot Care of Rhode Island PC Podiatrist CurrentSince Apr 1, 2022 Accepting new patients

Locations

160 West St
Ste 2
Milford, MA 01757
Phone (508) 473-2273

1376 Bronco Hwy
Oakland, RI 02858
Phone (401) 568-9980

1376 Bronco Hwy
#102
Oakland, RI 02858
Phone (401) 568-9980

301 Mendon Rd
Woonsocket, RI 02895
Phone (401) 741-9616

Interoperability endpoints

  • Direct secure messaging: dr.hart@ffc.directbygreenway.com

Organizations & group practices 3

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1801988647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MENDON ROAD",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "02895",
            "telephone_number": "401-769-5011",
            "fax_number": "401-769-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1376 BRONCOS HWY RTE 102",
            "city": "BURRILLVILLE",
            "state": "RI",
            "postal_code": "02858",
            "telephone_number": "401-568-9980",
            "fax_number": "401-769-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "2162",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH00848",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burrillville, RI

Sources for this page

Verify at the official NPI Registry.