NPIMap

Individual provider Active NPI

Timothy Snow

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1972921765
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2018-00264 Issued in NC
Practice address
1 Gustave L Place, Box 1149
New York, NY 10029
Phone
(802) 578-9543
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2018-00264 NC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Gustave L Place, Box 1149
New York, NY 10029

Mailing address

1 Gustave L Place, Box 1149
New York, NY 10029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180607000959 NC Practitioner - Emergency Medicine 8123383452 Reassigns benefits to 1 organization
I20210707002581 SC Practitioner - Emergency Medicine 8123383452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Vermont College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

3536 Mt Holly Huntersville Rd
Charlotte, NC 28216-8644
Phone (336) 716-2255

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018-00264NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Emergency Physicians of SC PC Emergency Medicine CurrentSince Jun 1, 2021 Accepting new patients
Wake Forest Emergency Providers CurrentSince Apr 1, 2024 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

3536 Mt Holly Huntersville Rd
Charlotte, NC 28216
Phone (704) 801-6500

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Interoperability endpoints

  • Direct secure messaging: tsnow2869601@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1972921765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L PLACE, BOX 1149",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L PLACE, BOX 1149",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "802-578-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNOW",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2018-00264",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.