NPIMap

Individual provider Active NPI

Timothy W Wyse, MD

  • Hospitalist Physician
  • Colorado Springs, CO
National Provider Identifier
1861482804
Registry record updated Jul 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
DR.0030194 Issued in CO
Practice address
2222 N Nevada Ave
Colorado Springs, CO 80907
Phone
(719) 776-8040
Fax
(719) 776-8050
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30194 CO
Hospitalist Physician 208M00000X DR.0030194 CO Primary

Addresses

Primary practice location

2222 N Nevada Ave
Colorado Springs, CO 80907

Mailing address

2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone (719) 776-8040

Other identifiers 1

IdentifierTypeStateIssuer
01301944MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20100203000569 CO Practitioner - HospitalistPractitioner - Family Practice 4688717309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
University of Washington School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

10860 New Allegiance Dr
Colorado Springs, CO 80921-3794
Phone (719) 776-8040

Hospital & facility affiliations

  • Centura Health-Penrose St Francis Health Services Hospital, Colorado Springs, CO, CCN 060031
  • St Mary-Corwin Hospital Hospital, Pueblo, CO, CCN 060012
  • Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30194COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Jul 1, 2018 Accepting new patients
Portercare Adventist Health System Hospitalist CurrentSince Jul 1, 2018 Accepting new patients
Portercare Adventist Health System CurrentSince Jul 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jul 1, 2018 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

2350 Meadows Blvd
Castle Rock, CO 80109
Phone (720) 248-3413

10860 New Allegiance Dr
Colorado Springs, CO 80921
Phone (719) 757-7000

6001 E Woodmen Rd
Fl 6
Colorado Springs, CO 80923
Phone (719) 571-6000

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

2222 N Nevada Ave
Ste 4001
Colorado Springs, CO 80907
Phone (719) 636-9393

2525 S Downing St
Denver, CO 80210
Phone (303) 744-2706

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1861482804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076819",
            "telephone_number": "719-776-8040",
            "fax_number": "719-776-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-776-8040",
            "fax_number": "719-776-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSE",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "30194",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0030194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01301944",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.