DR. TIMOTHY JOHN GILL M.D.
NPI 1134568215
Family Medicine in Allentown, PA

NPI Status: Active since June 21, 2013

Contact Information

410 N KROCKS RD
ALLENTOWN, PA
ZIP 18106
Phone: (888) 982-8594

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  • Individual
  • Male
  • Years of Experience 10
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About TIMOTHY GILL

This page provides the complete NPI Profile along with additional information for Timothy Gill, a primary care provider established in Allentown, Pennsylvania with a medical specialization in Family Medicine and more than 10 years of experience. He graduated from Drexel University College Of Medicine in 2016. The healthcare provider is registered in the NPI registry with number 1134568215 assigned on June 2013. The practitioner's primary taxonomy code is 207Q00000X with license number MT204860 (PA). The provider is registered as an individual and his NPI record was last updated 5 years ago.

NPI
1134568215
Provider Name
DR. TIMOTHY JOHN GILL M.D.
Gender
Male
Entity Type
Individual
Location Address
410 N KROCKS RD ALLENTOWN, PA 18106
Location Phone
(888) 982-8594
Mailing Address
649 N LEWIS RD SUITE 220 ROYERSFORD, PA 19468
Mailing Phone
(610) 396-5163
Medical School Name
DREXEL UNIVERSITY COLLEGE OF MEDICINE
Graduation Year
2016
Is Sole Proprietor?
No
Enumeration Date
06-21-2013
Last Update Date
04-02-2021
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A primary care provider (PCP) like Timothy Gill sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Secondary Locations

  • 41 E Kings Hwy
    Audubon, NJ 08106
    (888) 982-8594
  • 649 N Lewis Rd Suite 220
    Royersford, PA 19468
    (610) 396-5163

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
MT204860
License State
PA
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Timothy Gill is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Timothy Gill is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6709154610

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20170619001264

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 70 times for 21 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

This service was performed 44 times for 22 patients

Complete ultrasound scan of joint

A complete ultrasound scan of a joint is a non-invasive procedure using sound waves to create images of your joint. It helps identify problems like inflammation, injury, or disease. It's painless, safe, and doesn't involve radiation.

This service was performed 14 times for 14 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 118 times for 84 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 134 times for 97 patients

Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose

Hyaluronan or Euflexxa is a substance similar to a natural substance in your joints. It's injected into the joint space to treat pain from osteoarthritis, especially in the knee. It helps to lubricate the joint, reducing pain and improving mobility.

This service was performed 78 times for 17 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 236 times for 37 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 70 times for 70 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.22 for a new patient copayment and $24.2 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 18106 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $84.88
  • Minimum New Patient Price $54.64
  • Maximum New Patient Price $166.87
  • Average New Patient Copayment $21.22
  • Minimum New Patient Copayment $13.66
  • Maximum New Patient Copayment $41.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $96.82
  • Minimum Established Patient Price $17.33
  • Maximum Established Patient Price $135.84
  • Average Established Patient Copayment $24.2
  • Minimum Established Patient Copayment $4.33
  • Maximum Established Patient Copayment $33.96

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Care Plan 100% 331
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan
Engagement of New Medicaid Patients and Follow-upYesN/A
Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity.
Improved Practices that Disseminate Appropriate Self-Management MaterialsYesN/A
Provide self-management materials at an appropriate literacy level and in an appropriate language.
Pneumococcal Vaccination Status for Older Adults 73% 331
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 97% 366
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Screening for Osteoporosis for Women Aged 65-85 Years of Age 86% 183
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Timothy Gill is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
READING HOSPITAL420 S 5TH AVENUE
WEST READING, PA 19611
(610) 988-8000Acute Care Hospitals
POTTSTOWN HOSPITAL1600 EAST HIGH STREET
POTTSTOWN, PA 19464
(610) 327-7000Acute Care Hospitals
PHOENIXVILLE HOSPITAL140 NUTT ROAD
PHOENIXVILLE, PA 19460
(610) 983-1000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1134568215, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
3
Doubled → 6
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
2
Unchanged
Pos 9
1
Doubled → 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 5 → 10 → 1 8 → 16 → 7 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 1 + 0 + 6 + 1 + 6 + 2 + 2 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1134568215.

Other Providers at the Same Location


The following 13 providers are registered at the same or a nearby location.

Occupational Therapy Assistant
410 N KROCKS RD
ALLENTOWN, PA 18106
Physician Assistant
410 N KROCKS RD
ALLENTOWN, PA 18106
Physician Assistant (Medical)
410 N KROCKS RD
ALLENTOWN, PA 18106
Family Medicine
410 N KROCKS RD
ALLENTOWN, PA 18106
Physician Assistant (Medical)
410 N KROCKS RD
ALLENTOWN, PA 18106
Physician Assistant
410 N KROCKS RD
ALLENTOWN, PA 18106
Physician Assistant
410 N KROCKS RD
ALLENTOWN, PA 18106
Nurse Practitioner (Gerontology)
410 N KROCKS RD
ALLENTOWN, PA 18106
Nurse Practitioner (Primary Care)
410 N KROCKS RD
ALLENTOWN, PA 18106
Nurse Practitioner (Family)
410 N KROCKS RD
ALLENTOWN, PA 18106
Physician Assistant
410 N KROCKS RD
ALLENTOWN, PA 18106
Nurse Practitioner
410 N KROCKS RD
ALLENTOWN, PA 18106
Occupational Therapy Assistant
410 N KROCKS RD
ALLENTOWN, PA 18106

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134568215, enumerated as an "individual" on June 21, 2013.

The provider is located at 410 N KROCKS RD ALLENTOWN, PA 18106 and the phone number is (888) 982-8594.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter Health. Please consult your insurance carrier or call the provider to verify.

Timothy Gill is affiliated with: READING HOSPITAL, POTTSTOWN HOSPITAL and PHOENIXVILLE HOSPITAL.