Individual provider Active NPI

Timothy Burkholder

  • Anesthesiology Physician
  • Sandusky, OH
National Provider Identifier
1811380439
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
34.016381 Issued in OH
Practice address
1111 Hayes Ave
Sandusky, OH 44870-3323
Phone
(419) 557-7400
Fax
(440) 579-0167
NPI assigned
Mar 5, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34.016381 OH Primary

Addresses

Primary practice location

1111 Hayes Ave
Sandusky, OH 44870-3323

Mailing address

7757 Auburn Rd Ste 15
Concord Township, OH 44077-9604
Phone (440) 226-2596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230710001553 OH Practitioner - Anesthesiology 2163881079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Anesthesia Group, IncGroup PAC ID 9537222138, 130 clinicians

Practice addresses (Care Compare)

1111 Hayes Ave
Sandusky, OH 44870-3323
Phone (440) 226-2596

Hospital & facility affiliations

  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025

Merit-based Incentive Payment System (MIPS)

Final score
78.79 of 100Reported as group
Quality
71.01
Improvement activities
40
Cost
82.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Anesthesia Group, Inc Anesthesiology CurrentSince Dec 12, 2023 Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

7757 Auburn Rd
Ste 15
Concord Township, OH 44077
Phone (440) 709-9150

615 Fulton St
Port Clinton, OH 43452
Phone (419) 734-3131

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1811380439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD STE 15",
            "city": "CONCORD TOWNSHIP",
            "state": "OH",
            "postal_code": "440779604",
            "telephone_number": "440-226-2596",
            "fax_number": "440-579-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448703323",
            "telephone_number": "419-557-7400",
            "fax_number": "440-579-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHOLDER",
        "first_name": "TIMOTHY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-05",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "34.016381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.