Timothy Sean O'Kelley, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A11990 Issued in CA

Practice address

400 N Pepper Ave
Suite #1M107
Colton, CA 92324-1801

Phone

(909) 580-6370

NPI assigned

Oct 31, 2011

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

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Emergency Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

Merit-based Incentive Payment System (MIPS)

Final score

95.46 of 100Reported as individual

Quality

94.47

Improvement activities

40

Cost

80.32

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tokelley12539@skagit.direct-ci.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.

• Northwest Emergency Physicians LLC

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370
  Medicare reassignment Care Compare group NPD
• Eastside Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Issaquah, WA
  • NPI 1689683229
  Medicare reassignment NPD
• Eastside Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Everett, WA
  • NPI 1922303478
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Public Hospital Dist No 1 Skagit

  • General Acute Care Hospital
  • Mount Vernon, WA
  • NPI 1053357244
  Care Compare affiliation

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1962788224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "SUITE #1M107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "SUITE #1M107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KELLEY",
        "first_name": "TIMOTHY",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A11990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henrietta N Nwamu
• Darlington Nwite, RN
• Jane Nwokeabia
• Henry Nwosu, NP
• Martine Nyiramahirwe
• Jennifer Cecilia O'Neill, RDN
• Oasis Medical Center, Inc.
• Oasis Medical Center,Inc.
• Angelina Oba
• Brooklyn Ober, PA-C

• Emergency Medicine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.