Individual provider Active NPI

Timothy Roland Brown, M.D.

  • Surgery Physician
  • Canon City, CO
National Provider Identifier
1881633816
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28896 Issued in CO
Practice address
1335 Phay Ave Ste D
Canon City, CO 81212-2349
Phone
(719) 275-4061
Fax
(719) 275-4058
NPI assigned
Jun 5, 2006
Last updated
May 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28896 CO Primary

Addresses

Primary practice location

1335 Phay Ave Ste D
Canon City, CO 81212-2349

Mailing address

PO Box 1292
Canon City, CO 81215-1292
Phone (719) 275-4061

Other identifiers 1

IdentifierTypeStateIssuer
06575749MedicaidCO

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20050914000636 CO Practitioner - General SurgeryPractitioner - Other (Physician) 2961435540 Practice locations: Canon City, CO

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Texas Tech University Health Science Center School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

933 A Sell Ave
Canon City, CO 81212-1292
Phone (719) 275-4061

Merit-based Incentive Payment System (MIPS)

Final score
75.69 of 100Reported as group
Quality
71.4
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28896COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy R Brown MD CurrentSince Jan 1, 1990 Accepting new patients
Vincent T Yu MD PC Surgery Past Accepting new patients

Locations

1335 Phay Ave
Ste D
Canon City, CO 81212
Phone (719) 269-8820

933 Sell Ave
Unit A
Canon City, CO 81212
Phone (719) 275-0685

Organizations & group practices 2

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1881633816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1292",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812151292",
            "telephone_number": "719-275-4061",
            "fax_number": "719-275-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 PHAY AVE STE D",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122349",
            "telephone_number": "719-275-4061",
            "fax_number": "719-275-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIMOTHY",
        "middle_name": "ROLAND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "28896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06575749",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.