DR. TIMOTHY JAMES MARTIN M.D.
NPI 1154305175
Obstetrics & Gynecology in Overland Park, KS

NPI Status: Active since December 02, 2005

Contact Information

10600 QUIVIRA RD STE 200
OVERLAND PARK, KS
ZIP 66215
Phone: (913) 541-0990
Fax: (913) 541-1452

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  • Individual
  • Male
  • Years of Experience 39
  • Obstetrics & Gynecology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About TIMOTHY MARTIN

This page provides the complete NPI Profile along with additional information for Timothy Martin, a women's health care provider established in Overland Park, Kansas with a medical specialization in Obstetrics & Gynecology and more than 39 years of experience. He graduated from University Of Missouri, Kansas City, School Of Medicine in 1987. The healthcare provider is registered in the NPI registry with number 1154305175 assigned on December 2005. The practitioner's primary taxonomy code is 207V00000X with license number 423578 (KS). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1154305175
Provider Name
DR. TIMOTHY JAMES MARTIN M.D.
Gender
Male
Entity Type
Individual
Location Address
10600 QUIVIRA RD STE 200 OVERLAND PARK, KS 66215
Location Phone
(913) 541-0990
Location Fax
(913) 541-1452
Mailing Address
10600 QUIVIRA RD STE 200 OVERLAND PARK, KS 66215
Mailing Phone
(913) 541-0990
Mailing Fax
(913) 541-1452
Medical School Name
UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduation Year
1987
Is Sole Proprietor?
No
Enumeration Date
12-02-2005
Last Update Date
03-06-2020
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Women's health care providers like Timothy Martin treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

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

Obstetrics & Gynecology

Taxonomy Code
207V00000X
Type
Allopathic & Osteopathic Physicians
License No.
423578
License State
KS
Taxonomy Description
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1174400000XOther Service Providers

Specialist

423578 (KS)

Insurance Plans Accepted

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

  • Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Catastrophic Pathway (+ Incentives) - EPO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Silver Pathway 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 7200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Blue KC Catastrophic BlueSelect EPO - EPO
  • Blue KC Choice Bronze 2 with Spira Care BlueSelect EPO - EPO
  • Blue KC Choice Silver 1 with Spira Care BlueSelect EPO - EPO
  • Blue KC Community Silver Preferred-Care Blue EPO - EPO
  • Blue KC First Bronze Preferred-Care Blue EPO - EPO
  • Blue KC Standard Bronze BlueSelect EPO - EPO
  • Blue KC Standard Bronze Preferred-Care Blue EPO - EPO
  • Blue KC Standard Gold BlueSelect EPO - EPO
  • Blue KC Standard Gold Preferred-Care Blue EPO - EPO
  • Blue KC Standard Silver BlueSelect EPO - EPO
  • Blue KC Standard Silver Preferred-Care Blue EPO - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

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

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
100127710AMEDICAID (05)KS 

Medicare Participation & PECOS Enrollment Status

Timothy Martin 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 Martin 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: 3072562859

    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: I20100525000636

    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.

Cervical or vaginal cancer screening; pelvic and clinical breast examination

This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.

This service was performed 19 times for 19 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 17 times for 16 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 23 times for 21 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $30.6 for a new patient copayment and $16.6 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 66215 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $122.41
  • Minimum New Patient Price $53
  • Maximum New Patient Price $161.67
  • Average New Patient Copayment $30.6
  • Minimum New Patient Copayment $13.25
  • Maximum New Patient Copayment $40.41

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.4
  • Minimum Established Patient Price $16.88
  • Maximum Established Patient Price $132.11
  • Average Established Patient Copayment $16.6
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $33.02

* 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
Breast Cancer Screening 88% 24
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Colorectal Cancer Screening 67% 24
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Documentation of Current Medications in the Medical Record 100% 109
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Implementation of formal quality improvement methods, practice changes, or other practice improvement processesYesN/A
Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following such as: • Multi-Source Feedback; • Train all staff in quality improvement methods; • Integrate practice change/quality improvement into staff duties; • Engage all staff in identifying and testing practices changes; • Designate regular team meetings to review data and plan improvement cycles; • Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff; and/or • Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changesYesN/A
Ensure full engagement of clinical and administrative leadership in practice improvement that could include one or more of the following: Make responsibility for guidance of practice change a component of clinical and administrative leadership roles; Allocate time for clinical and administrative leadership for practice improvement efforts, including participation in regular team meetings; and/or Incorporate population health, quality and patient experience metrics in regular reviews of practice performance.
Patient-Specific Education 73% 22
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 57% 28
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
Preventive Care and Screening: Influenza Immunization 37% 30
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Provide Patient Access 95% 22
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 73% 22
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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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 1154305175, 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 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 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
5
Doubled → 10 → 1 + 0
Pos 4
4
Unchanged
Pos 5
3
Doubled → 6
Pos 6
0
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
1
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
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 5 → 10 → 1 3 → 6 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 0 + 4 + 6 + 0 + 1 + 0 + 1 + 1 + 4 + 24 = 45

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

The next multiple of ten after 45 is 50. The difference is the calculated check digit.

50 - 45 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1154305175.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
10600 QUIVIRA RD STE 200
OVERLAND PARK, KS 66215
Physician Assistant
10600 QUIVIRA RD STE 200
OVERLAND PARK, KS 66215
Obstetrics & Gynecology
10600 QUIVIRA RD STE 200
OVERLAND PARK, KS 66215
Specialist
10600 QUIVIRA RD STE 200
OVERLAND PARK, KS 66215

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1154305175, enumerated as an "individual" on December 02, 2005.

The provider is located at 10600 QUIVIRA RD STE 200 OVERLAND PARK, KS 66215 and the phone number is (913) 541-0990.

Obstetrics & Gynecology with taxonomy code 207V00000X.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Blue Cross and. Please consult your insurance carrier or call the provider to verify.