Individual provider Active NPI

Timothy Marshall, PA-C

  • Surgical Physician Assistant
  • Hilton Head Island, SC
National Provider Identifier
1861948804
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1131902 Issued in PA
Practice address
25 Hospital Center Blvd Ste 306
Hilton Head Island, SC 29926-2739
Phone
(843) 689-8224
NPI assigned
Aug 30, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1131902 PA Primary

Addresses

Primary practice location

25 Hospital Center Blvd Ste 306
Hilton Head Island, SC 29926-2739

Mailing address

203 Midfield Circle Dr
MC Donald, PA 15057-2379

Other practice location 1

6150 E Broad St
Columbus, OH 43213-1574
Phone (614) 546-4008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190603001412 SC Practitioner - Physician Assistant 5597043299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Pittsburgh School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hilton Head Regional Physician Group LLCGroup PAC ID 9234573676, 114 clinicians

Practice addresses (Care Compare)

25 Hospital Ctr Blvd
Hilton Head, SC 29926-2738
Phone (843) 689-8149

8 Hospital Ctr Blvd
Hilton Head, SC 29926-8701

Hospital & facility affiliations

  • Pruitthealth Home Health-Low Country Home health agency, Bluffton, SC, CCN 427123
  • Novant Health Hilton Head Medical Center Hospital, Hilton Head Island, SC, CCN 420080

Merit-based Incentive Payment System (MIPS)

Final score
79.72 of 100Reported as group
Quality
63.11
Promoting interoperability
100
Improvement activities
40
Cost
69.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1131902PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hilton Head Regional Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
Hilton Head Regional Physician Group LLC CurrentSince Feb 1, 2024 Accepting new patients
Hilton Head Heart PA Past Accepting new patients

Locations

25 Hospital Ctr
Ste 300
Hilton Head Island, SC 29926
Phone (843) 681-8203

25 Hospital Ctr
Ste 306
Hilton Head Island, SC 29926
Phone (843) 681-2074

8 Hospital Center Blvd
Ste 130
Hilton Head Island, SC 29926
Phone (843) 682-2740

Interoperability endpoints

  • Direct secure messaging: timothy.marshall.1@30548.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1861948804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MIDFIELD CIRCLE DR",
            "city": "MC DONALD",
            "state": "PA",
            "postal_code": "150572379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL CENTER BLVD STE 306",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299262739",
            "telephone_number": "843-689-8224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6150 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131574",
            "country_code": "US",
            "telephone_number": "614-546-4008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "1131902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head Island, SC

Sources for this page

Verify at the official NPI Registry.