Timothy J Zielicke, D.O.

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

O-1548 Issued in ID

Practice address

3551 E Overland Rd
Meridian, ID 83642-6757

Phone

(208) 884-1333

NPI assigned

Jun 12, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, ID2 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

Specialty

Physical Medicine and Rehabilitation

Education

Pacific Medical College, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Relief Institute LLCGroup PAC ID 3779730908, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tzielicke@nwsh.gwaydirect.com

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.

• Pain Relief Institute, LLC

  • Interventional Pain Medicine Physician
  • Medford, OR
  • NPI 1629331293
  Medicare reassignment Care Compare group NPD
• Idaho Physical Medicine and Rehabilitation PA

  • Physical Medicine & Rehabilitation Physician
  • Meridian, ID
  • NPI 1497711329

  Pain Medicine

  Medicare reassignment NPD
• Pacific Sports and Interventional Spine, LLC

  • Interventional Pain Medicine Physician
  • Springfield, OR
  • NPI 1881186336

  General Practice

  Medicare reassignment NPD
• Pacific Sports and Interventional Spine, LLC-P

  • Interventional Pain Medicine Physician
  • Sutherlin, OR
  • NPI 1215898564
  NPD
• Rogue Valley Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Medford, OR
  • NPI 1336479021
  NPD (past)

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1841638723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 E OVERLAND RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426757",
            "telephone_number": "208-884-1333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 N Mineral Dr",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838159169",
            "country_code": "US",
            "telephone_number": "208-457-4208",
            "fax_number": "208-457-4197",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1641 E Polston Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838547852",
            "country_code": "US",
            "telephone_number": "208-457-4208",
            "fax_number": "208-457-4197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIELICKE",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "ID",
            "license": "O-1548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841638723",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara F Zeller, APNP
• Zelus Recovery LLC
• Jason Paul Zelus
• Nikole Ladeen Zetterberg
• Sean Elliot Ziegler, DMD
• Katelyn L Ziemann, LMT
• Paige Ziemer, FNP
• Damon Bernard Zimmerman, MA
• Heather R Zimmerman
• Terisa Joann Zimmerman, MS, LAT, ATC

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.