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DR. TIMOTHY EDWARD NISSEN DO
NPI 1114480217
Pediatrics - Pediatric Cardiology in Little Rock, AR

Active since April 08, 2019PECOS EnrolledAccepts Medicare Assignment
1 CHILDRENS WAY # 512-19A, LITTLE ROCK, AR 72202(501) 364-1874 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 14, 2025, Apr 8, 2019 (2 updates tracked since 2019).

About Dr. Timothy Edward Nissen Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIMOTHY EDWARD NISSEN DO (NPI 1114480217) is an individual pediatric cardiology provider in Little Rock, Arkansas, licensed in Arkansas (E-15736) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Little Rock, and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2019).

NPPES Registry Identity

NPI1114480217
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameDR. TIMOTHY EDWARD NISSENCredential: DO
Location Address1 CHILDRENS WAY # 512-19ALittle Rock, AR 72202-3500
Mailing Address4019 Valley View DrLittle Rock, AR 72212-2097 · (501) 993-3373
Phone(501) 364-1874
Sole ProprietorNo
Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2019
Enumeration DateApril 8, 2019
Last NPPES UpdateAugust 25, 20252 updates tracked since enumeration
NPPES CertifiedAugust 25, 2025
✔ NPI 1114480217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in AR · E-15736
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedPediatricsTaxonomy 208000000X · License E-15736 (AR)
1 CHILDRENS WAY # 512-19A, Little Rock, AR 72202
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Secondary Practice Location 1

Location 14301 W Markham St # 783Little Rock, AR 72205-7101 · Phone (501) 686-8000 · Fax (501) 526-5148

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Timothy Edward Nissen Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284969734
PECOS Enrollment IDI20250908002024
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Timothy Nissen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Arkansas For Medical Sciences
3.2 mi
Family Medicine
1401 W CAPITOL AVE
Little Rock, AR 72201
  • Reassigned Medicare billing, Arkansas enrollment
  • 2,038 clinicians in this Medicare group
NPI 1932872975 (501) 686-8000
Arkansas Childrens Professional Services Organization LLC
3.4 mi
Pediatrics
1 CHILDRENS WAY
Little Rock, AR 72202
  • Reassigned Medicare billing, Arkansas enrollment
  • 653 clinicians in this Medicare group
NPI 1629889464 (501) 364-2526

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JONATHAN L ASKINS JR. MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-5155
HEMA JOSHI
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
MYIA DICKERSON DO
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-5115
JENNIFER BRITO WARNER MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (479) 364-5115
DR. LESLIE HELENE ST. PIERRE MD
Pediatrics
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-5115
MAKENZIE LAINE NIVEN MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
DR. HAMSINI MOVVA MBBS
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
MOIRA ELAINE MOORE MD, MPH
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-5115

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Nissen's NPI number?

The NPI number for Timothy Nissen is 1114480217. It was assigned to this individual provider in the NPPES registry on April 8, 2019.

Where is Timothy Nissen located?

Timothy Nissen practices at 1 Childrens Way # 512-19a, Little Rock, AR 72202. The listed phone number is (501) 364-1874.

What is Timothy Nissen's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Timothy Nissen enrolled in Medicare?

Yes. Timothy Nissen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Timothy Nissen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Nissen reassigns Medicare benefits to 2 organizations: University Of Arkansas For Medical Sciences (Little Rock, AR) and Arkansas Childrens Professional Services Organization LLC (Little Rock, AR). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Nissen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Timothy Nissen accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Timothy Nissen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Timothy Nissen was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.