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TIMOTHY IM PA-C
NPI 1215423702
Physician Assistant in New York, NY

Active since July 08, 2018PECOS Enrolled
114 W 17TH ST, NEW YORK, NY 10011(212) 321-7003 Get Directions Write a Review

NPPES record last updated: December 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 1, 2022, Aug 29, 2018, Jul 8, 2018 (3 updates tracked since 2018).

About Timothy Im Pa-c NPPES

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

TIMOTHY IM PA-C (NPI 1215423702) is an individual physician assistant in New York, New York, licensed in New York (022440) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Bronx, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1215423702
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameTIMOTHY IMCredential: PA-C
Location Address114 W 17TH STNew York, NY 10011-5433
Mailing Address129 W 29th St Fl 10New York, NY 10001-5105 · (415) 458-6791
Phone(212) 321-7003
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 8, 2018
Last NPPES UpdateDecember 1, 20223 updates tracked since enumeration
NPPES CertifiedDecember 1, 2022
✔ NPI 1215423702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NY · 022440
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
114 W 17TH ST, New York, NY 10011
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Secondary Practice Location 1

Location 11065 Southern BlvdBronx, NY 10459 · Phone (718) 589-2440

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy Im Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678814761
PECOS Enrollment IDI20190418002019
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10011 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

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

MELODY MARTIN
Family Medicine
114 W 17TH ST
NEW YORK, NY 10011
New York County (888) 663-6331
SHERRYLEEN ELISCA PA-C
Physician Assistant
114 W 17TH ST
NEW YORK, NY 10011
New York County (212) 321-7003
COURTNEY ALFRED JONES D.O.
Family Medicine
114 W 17TH ST
NEW YORK, NY 10011
New York County (212) 321-7003
ALICIA CAMPIGLIA PA
Nurse Practitioner
114 W 17TH ST
NEW YORK, NY 10011
New York County (212) 321-7003
AMY YUAN SUN MD
Family Medicine
114 W 17TH ST
NEW YORK, NY 10011
New York County (212) 321-7003
ERIC GALEN LE CLAIR PA-C
Physician Assistant
114 W 17TH ST
NEW YORK, NY 10011
New York County (212) 321-7003
MS. LINDSEY ANNE SKINNER ARNP, FNP-BC
Nurse Practitioner (Family)
114 W 17TH ST
NEW YORK, NY 10011
New York County (212) 321-7003
DR. ALEXANDRA JANE SCHLOSS MD
Family Medicine
114 W 17TH ST
NEW YORK, NY 10011
New York County (415) 658-6791

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 Im's NPI number?

The NPI number for Timothy Im is 1215423702. It was assigned to this individual provider in the NPPES registry on July 8, 2018.

Where is Timothy Im located?

Timothy Im practices at 114 W 17th St, New York, NY 10011. The listed phone number is (212) 321-7003.

What is Timothy Im's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Timothy Im enrolled in Medicare?

Yes. Timothy Im is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Timothy Im was last updated on December 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.