Individual provider Active NPI

Timothy Charles Childers, M.D.

  • Surgery Physician
  • Winter Park, FL
National Provider Identifier
1982609921
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME73071 Issued in FL
Practice address
1181 Orange Ave
Winter Park, FL 32789-4907
Phone
(407) 647-1331
Fax
(407) 571-2757
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME73071 FL Primary

Addresses

Primary practice location

1181 Orange Ave
Winter Park, FL 32789-4907

Mailing address

1181 Orange Ave
Winter Park, FL 32789-4907
Phone (407) 647-1331

Other identifiers 2

IdentifierTypeStateIssuer
020050628OtherFLPALMETTO GBA - RAILROAD MEDICARE
258553700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100625000295 FL Practitioner - General Surgery 8224169891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Florida College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

1181 Orange Ave
Winter Park, FL 32789-4907
Phone (407) 647-1331

Hospital & facility affiliations

  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score
92.17 of 100Reported as group
Quality
88.33
Improvement activities
40
Cost
77.07

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)12
Hernia repair (minimally invasive)26
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of Central Florida PA Specialist CurrentSince Jul 1, 2000 Accepting new patients
QSS-Southeast Clinical Services LLC Surgery CurrentSince Jun 12, 2017 Accepting new patients
North Florida Surgeons, PA CurrentSince Feb 1, 2025 Accepting new patients
North Florida Surgeons, PA Surgery CurrentSince Feb 1, 2025 Accepting new patients

Locations

36468 Emerald Coast Pkwy
Ste 1101
Destin, FL 32541
Phone (850) 290-2154

1340 S 18th St
Ste 104
Fernandina Beach, FL 32034
Phone (904) 277-3277

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

4215 Edgewater Dr
Orlando, FL 32804
Phone (407) 539-2000

1181 Orange Ave
Winter Park, FL 32789
Phone (407) 571-2751

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: timothy.childers.1@9109.direct.athenahealth.com
  • Direct secure messaging: timothy.childers.1@32979.direct.athenahealth.com

Organizations & group practices 4

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 2

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1982609921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1181 ORANGE AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894907",
            "telephone_number": "407-647-1331",
            "fax_number": "407-571-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 ORANGE AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894907",
            "telephone_number": "407-647-1331",
            "fax_number": "407-571-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "TIMOTHY",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME73071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "020050628",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258553700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.