NPIMap

Individual provider Active NPI

Timothy Francis Quinn, PA-C

  • Physician Assistant
  • Faulkton, SD
National Provider Identifier
1811967060
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0488 Issued in SD
Practice address
1300 Oak Street
Faulkton, SD 57438-0100
Phone
(605) 598-6262
NPI assigned
Jan 23, 2006
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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 0488 SD Primary

Addresses

Primary practice location

1300 Oak Street
Faulkton, SD 57438-0100

Mailing address

PO Box 100
1300 Oak Street
Faulkton, SD 57438-0100
Phone (605) 598-6262

Other identifiers 1

IdentifierTypeStateIssuer
6823802MedicaidSD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TIM.QUINN@famc.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20051017000662 SD Practitioner - Physician Assistant 4981620226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faulkton Area Medical CenterGroup PAC ID 4880505866, 10 clinicians

Practice addresses (Care Compare)

1300 Oak St
Faulkton, SD 57438-2149
Phone (605) 598-1144

PO Box
Suite 100
Faulkton, SD 57438

PO Box
Suite 100
Faulkton, SD 57438-0100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0488SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Faulkton Area Medical Center CurrentSince Jul 1, 2006 Accepting new patients
Hoven Medical Clinic Inc. Past Accepting new patients
Faulkton Area Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tim.quinn@famc.cernerdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1811967060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "address_2": "1300 OAK STREET",
            "city": "FAULKTON",
            "state": "SD",
            "postal_code": "574380100",
            "telephone_number": "605-598-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 OAK STREET",
            "city": "FAULKTON",
            "state": "SD",
            "postal_code": "574380100",
            "telephone_number": "605-598-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "TIMOTHY",
        "middle_name": "FRANCIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6823802",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TIM.QUINN@famc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Faulkton Area Medical Center Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1300 Oak Street",
            "city": "Faulkton",
            "state": "SD",
            "country_code": "US",
            "postal_code": "574380100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Faulkton, SD

Sources for this page

Verify at the official NPI Registry.