Active NPI
Timothy Martin Phillips, MD
- Pediatric Urology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Urology Physician
- License
- 2018010765
- Practice address
- 1465 S Grand Blvd
Saint Louis, MO 63104-1003 - Phone
- (210) 857-4174
- Fax
- (314) 268-4176
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Urology Physician | 2088P0231X | N6582 | TX | |
| Pediatric Urology Physician | 2088P0231X | 2018010765 | MO | Primary |
Addresses
Primary practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (210) 857-4174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 286858001 | Medicaid | TX |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tphillips238186@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Uniformed Services Uhs Fe Hebert School of Med, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10101 Woodfield LN
Saint Louis, MO 63132-2946
Phone (608) 280-4647
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5641
Hospital & facility affiliations
- SSM Health St Mary'S Hospital - St Louis
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 68.52
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.22
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018010765 | MO | MD | Pediatric Urology Physician |
| N6582 | TX | MD | Pediatric Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SSM Health Care Group | Current | Accepting new patients | |
| Magella Medical Associates Billing, Inc. | Current | Accepting new patients | |
| SSM Cardinal Glennon Childrens Hospital | Current | Accepting new patients | |
| SSM Health Care Group | Current | Accepting new patients | |
| SSM Cardinal Glennon Children'S Hospital | Current | Accepting new patients | |
| SSM Medical Group Inc. | Past | Accepting new patients |
Locations
7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189
3403 Anderson Healthcare Dr
#B
Edwardsville, IL 62025
Phone (618) 288-5606
1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070
10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647
3635 Vista Ave
Saint Louis, MO 63110
Phone (314) 577-8022
1465 S Grand Blvd
Fl 1
Saint Louis, MO 63104
Phone (314) 678-2171
3691 Rutger St
Saint Louis, MO 63110
Phone (314) 268-4101
3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115
3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855
Interoperability endpoints
- tphillips238186@direct-ehr-ssmhc.com
- tphillips67984@direct.nemours.org
Organizations & group practices 6
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.
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-
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- NPI 1083631071
-
- Pediatrics Physician
- Warrenton, MO
- NPI 1962573212
-
- Dermatopathology Physician
- Saint Louis, MO
- NPI 1932844495
-
- Durable Medical Equipment & Medical Supplies
- Fenton, MO
- NPI 1124579966
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1336387836
-
- General Acute Care Hospital
- Saint Louis, MO
- NPI 1962572396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1992724595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "210-857-4174",
"fax_number": "314-268-4176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "210-857-4174",
"fax_number": "314-268-4176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "TIMOTHY",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2021-01-15",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "TX",
"license": "N6582",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "MO",
"license": "2018010765",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286858001",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tphillips238186@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "tphillips238186@direct-ehr-ssmhc.com",
"address_1": "1465 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041003",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1465 S Grand Blvd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631041003",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.