Individual provider Active NPI

Nadia Lynn Tymkowych, M.D.

  • Family Medicine Physician
  • Council Bluffs, IA
National Provider Identifier
1831437235
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD-43174 Issued in IA
Practice address
1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone
(712) 396-4340
Fax
(712) 396-4180
NPI assigned
Jan 21, 2013
Last updated
Mar 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD-43174 IA Primary

Addresses

Primary practice location

1 Edmundson PL
Council Bluffs, IA 51503-4658

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 2

IdentifierTypeStateIssuer
1831437235MedicaidIA
47068731712MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, SD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160218000337 IA Practitioner - Family Practice 7719118728 Reassigns benefits to 1 organization
I20171003007767 SD Practitioner - Family Practice 7719118728 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6884NEMDDentist
MD-43174IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. Family Medicine CurrentSince Aug 8, 2017 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Nov 8, 2022 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Network, Inc. Family Medicine CurrentSince Aug 8, 2017 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Nov 8, 2022 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
City of Brookings Current Accepting new patients

Locations

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

61 Charles St
Deadwood, SD 57732
Phone (605) 717-6000

1620 N 7th St
Rapid City, SD 57701
Phone (605) 343-4958

2500 Arrowhead Dr
Rapid City, SD 57702
Phone (317) 370-2013

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

Interoperability endpoints

  • Direct secure messaging: ntymkowych.12600@regionalhealth.sdhealthlink.net

Organizations & group practices 8

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": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1831437235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDMUNDSON PL",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034658",
            "telephone_number": "712-396-4340",
            "fax_number": "712-396-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYMKOWYCH",
        "first_name": "NADIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-21",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "MD-43174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831437235",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731712",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.