NPIMap

Individual provider Active NPI

Timothy Michael Wimmer, M.D.

  • Orthopaedic Surgery Physician
  • Eureka, CA
National Provider Identifier
1811955735
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
C54546 Issued in CA
Practice address
2826 Harris St
Eureka, CA 95503-4809
Phone
(707) 443-8066
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X IN 01055470 IN
Orthopaedic Surgery Physician 207X00000X C54546 CA Primary

Addresses

Primary practice location

2826 Harris St
Eureka, CA 95503-4809

Mailing address

1543 9TH Ave
San Diego, CA 92101-2877
Phone (619) 230-1510

Other practice location 1

34800 Bob Wilson Dr
Suite 112
San Diego, CA 92134-1098
Phone (619) 532-8439

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twimmer1664504@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110817000837 CA Practitioner - Orthopedic Surgery 0446429989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

2826 Harris St
Eureka, CA 95503-4809
Phone (707) 443-8066

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)25
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C54546CAMDOrthopaedic Surgery Physician
IN 01055470INMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Mar 8, 2021 Accepting new patients
Providence Medical Foundation CurrentSince Mar 8, 2021 Accepting new patients
Providence Medical Foundation Past Accepting new patients
Tri-City Hospital Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

2826 Harris St
Eureka, CA 95503
Phone (707) 443-8066

3304 Renner Dr
Fortuna, CA 95540
Phone (707) 725-4477

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Interoperability endpoints

  • Direct secure messaging: twimmer1664504@oc.providencedirect.org

Organizations & group practices 5

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 6

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1811955735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 9TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012877",
            "telephone_number": "619-230-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034809",
            "telephone_number": "707-443-8066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_2": "Suite 112",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "619-532-8439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIMMER",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "IN 01055470",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "C54546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twimmer1664504@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2826 Harris St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955034809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.