Timothy P Rearden, MD

Primary specialty

Medical Oncology PhysicianTaxonomy code 207RX0202X

License

R2H83 Issued in MO

Practice address

1255 Graham Rd
Div Im Medical Oncology, Ste 101
Florissant, MO 63031-8014

Phone

(800) 647-2098

Fax

(314) 362-3192

NPI assigned

Aug 4, 2006

Last updated

Nov 15, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trearden154905@direct.carenet.org

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.

• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1992746903
  Medicare reassignment
• Midwest Hematology Oncology Consultants LTD

  dba Hematology Oncology Consultants Inc

  • Hematology & Oncology Physician
  • Saint Louis, MO
  • NPI 1669496261
  NPD
• Saint Anthony's Physician Group

  • Internal Medicine Physician
  • Alton, IL
  • NPI 1750497319
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1962410829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8056",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "800-647-2098",
            "fax_number": "314-362-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 GRAHAM RD",
            "address_2": "DIV IM MEDICAL ONCOLOGY, STE 101",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318014",
            "telephone_number": "800-647-2098",
            "fax_number": "314-362-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDEN",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MO",
            "license": "R2H83",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207853003",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1255 Graham Rd",
            "address_2": "Div IM Medical Oncology, Ste 101",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Medical Oncology Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Medical Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.