Individual provider Active NPI

Mark Leo Timmerman, M.D.

  • Family Medicine Physician
  • Merrimack, NH
National Provider Identifier
1972525574
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
NH 7663 Issued in NH
Practice address
454 Daniel Webster Hwy
Merrimack, NH 03054-3699
Phone
(603) 424-8120
Fax
(603) 424-8140
NPI assigned
Jul 24, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NH 7663NHMDFamily Medicine Physician
7663NHMDRecreation Therapist

Interoperability endpoints

  • Direct secure messaging: mtimmerman@mvfp.directglo.com

Hospital & facility affiliations 6

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": "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrimack, NH

Sources for this page

Verify at the official NPI Registry.