Individual provider Active NPI

Timothy M Kump, DPM

  • Foot & Ankle Surgery Podiatrist
  • Towanda, PA
National Provider Identifier
1841294485
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC003249L Issued in PA
Practice address
1786 Golden Mile Rd
Suite 1
Towanda, PA 18848-9733
Phone
(570) 265-7700
Fax
(570) 268-4266
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC003249L PA Primary

Addresses

Primary practice location

1786 Golden Mile Rd
Suite 1
Towanda, PA 18848-9733

Mailing address

PO Box 376
Wysox, PA 18854-0376
Phone (570) 265-7700

Other identifiers 1

IdentifierTypeStateIssuer
001964262MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040206000828 PA Practitioner - Podiatry 1355234824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1786 Golden Mile Rd
Suite 1
Towanda, PA 18848-9733
Phone (570) 265-7700

Hospital & facility affiliations

  • Robert Packer Hospital Hospital, Sayre, PA, CCN 390079

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue12
Removal of nail tissue575
Removal or shaving of skin growth244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC003249LPAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bradford Foot and Ankle Specialties Foot & Ankle Surgery CurrentSince Jan 18, 2011 Accepting new patients
Bradford Foot and Ankle Specialties PastSince Jan 1, 1990 Accepting new patients
Community Health Associates Past Accepting new patients

Locations

1786 Golden Mile Rd
#1
Towanda, PA 18848
Phone (570) 265-7700

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.

Hospital & facility affiliations 2

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1841294485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 376",
            "city": "WYSOX",
            "state": "PA",
            "postal_code": "188540376",
            "telephone_number": "570-265-7700",
            "fax_number": "570-268-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 GOLDEN MILE RD",
            "address_2": "SUITE 1",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188489733",
            "telephone_number": "570-265-7700",
            "fax_number": "570-268-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMP",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC003249L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001964262",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towanda, PA

Sources for this page

Verify at the official NPI Registry.