Active NPI
Mark Leo Timmerman, M.D.
- Family Medicine Physician
- Merrimack, NH
National Provider Identifier
1972525574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- NH 7663
- Practice address
- 454 Daniel Webster Hwy
Merrimack, NH 03054-3699 - Phone
- (603) 424-8120
- Fax
- (603) 424-8140
- NPI assigned
- Jul 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | NH 7663 | NH | Primary |
Addresses
Primary practice location
454 Daniel Webster Hwy
Merrimack, NH 03054-3699
Mailing address
454 Daniel Webster Hwy
Merrimack, NH 03054-3695
Phone (603) 424-8120
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140824540 | Other | MA | BC/BS MASS BILLING # |
| 30D0084963 | Other | NH | CLIA NUMBER |
| 0103422YPNH01 | Other | NH | BC/BS INDIVIDUAL NUMBER |
| NH 7663 | Other | NH | NH STATE LICENSE |
| B86207 | Other | NH | HPHC BILLING NUMBER |
| 50Y095600NH01 | Other | NH | BC/BS NH GROUP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050506000067 | NH | Practitioner - Family Practice | 7719927060 | Practice locations: Manchester, NH |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Iowa, RJ & L Carver College of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
454 Daniel Webster Hwy
Manchester, NH 03054-3699
Phone (603) 424-8120
Hospital & facility affiliations
- Amedisys Home Health
- Home Health & Hospice Care
- Southern NH Medical Center
- Elliot Hospital
- St Joseph Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NH 7663 | NH | MD | Family Medicine Physician |
| 7663 | NH | MD | Recreation Therapist |
Interoperability endpoints
- mtimmerman@mvfp.directglo.com
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Nashua, NH
- NPI 1245447994
-
- Home Health Agency
- Portsmouth, NH
- NPI 1326230251
-
- General Acute Care Hospital
- Manchester, NH
- NPI 1902996028
-
- Home Health Agency
- Merrimack, NH
- NPI 1437151651
-
- General Acute Care Hospital
- Nashua, NH
- NPI 1093787384
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1972525574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "454 DANIEL WEBSTER HWY",
"city": "MERRIMACK",
"state": "NH",
"postal_code": "030543695",
"telephone_number": "603-424-8120",
"fax_number": "603-424-8140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "454 DANIEL WEBSTER HWY",
"city": "MERRIMACK",
"state": "NH",
"postal_code": "030543699",
"telephone_number": "603-424-8120",
"fax_number": "603-424-8140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMMERMAN",
"first_name": "MARK",
"middle_name": "LEO",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NH",
"license": "NH 7663",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS MASS BILLING #",
"identifier": "140824540",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA NUMBER",
"identifier": "30D0084963",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS INDIVIDUAL NUMBER",
"identifier": "0103422YPNH01",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NH STATE LICENSE",
"identifier": "NH 7663",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC BILLING NUMBER",
"identifier": "B86207",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS NH GROUP NUMBER",
"identifier": "50Y095600NH01",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Merrimack, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.