Timothy Louis Gieseke, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G34398 Issued in CA

Practice address

3536 Mendocino Ave
300
Santa Rosa, CA 95403-3634

Phone

(707) 546-2180

Fax

(707) 546-2188

NPI assigned

Jul 14, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal Medicine

Education

University of California, Irvine, California College of Medicine, 1976

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spring Lake Village Nursing home, Santa Rosa, CA, CCN 555268

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Front Porch Communities and Services

  • Skilled Nursing Facility
  • Santa Rosa, CA
  • NPI 1609549112

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1992703706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-575-6049",
            "fax_number": "707-546-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 MENDOCINO AVE",
            "address_2": "300",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954033634",
            "telephone_number": "707-546-2180",
            "fax_number": "707-546-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIESEKE",
        "first_name": "TIMOTHY",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G34398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G343980",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILDROAD MEDICARE",
            "identifier": "P00602516",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00G343980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Catherine Giarratana - Young, NP
• Haley Gibson, LMFT
• Kelly A Gibson, AU.D.
• Carol Suzanne Gieg, LCSW
• Sophia Giegerich, AMFT
• Breanna Leigh Gieseker, CMT
• Eli Gifford, AMFT
• Jotham Kahoro Gikuhi, FNP
• Eugenia Maria Gil, FNP-BC
• Danielle Marie-Caballero Gilardi

• Internal Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.