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DR. TIMOTHY JUSTIN GILLENWATER M.D.
NPI 1275763922
Plastic Surgery in Los Angeles, CA

Active since July 15, 2009PECOS Enrolled
1450 SAN PABLO ST STE 6200, LOS ANGELES, CA 90033(323) 442-7920 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 11, 2020, Feb 26, 2020 (2 updates tracked since 2020).

About Dr. Timothy Justin Gillenwater M.d. NPPES

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

DR. TIMOTHY JUSTIN GILLENWATER M.D. (NPI 1275763922) is an individual plastic surgery provider in Los Angeles, California, licensed in California (A108333) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275763922
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameDR. TIMOTHY JUSTIN GILLENWATERCredential: M.D.
Location Address1450 SAN PABLO ST STE 6200Los Angeles, CA 90033-5331
Mailing AddressPo Box 31309Los Angeles, CA 90031-0309 · (323) 442-7920
Phone(323) 442-7920
Sole ProprietorNo
Enumeration DateJuly 15, 2009
Last NPPES UpdateNovember 27, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2020
✔ NPI 1275763922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in CA · A108333
Definition

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

1450 SAN PABLO ST STE 6200, Los Angeles, CA 90033
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Timothy Justin Gillenwater M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 90033 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
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 20

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

SARAH KIM PA-C
Physician Assistant
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 442-9062
ELIZABETH CHANG PAC-C
Physician Assistant
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 442-9062
DR. CHRISTINE HSIEH M.D.
Colon & Rectal Surgery
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 865-3690
JIHYUN LEE PA-C
Physician Assistant (Medical)
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 865-3690
AZADEH AZARBAYEJANI CARR M.D.
Surgery (Surgical Oncology)
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 442-9062
DR. KYLE G COLOGNE M.D.
Colon & Rectal Surgery
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 865-3690
DR. SEAN CONOR WIGHTMAN M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 442-9062
JAMES DIEN TU NGUYEN MD
Surgery
1450 SAN PABLO ST STE 6200
LOS ANGELES, CA 90033
Los Angeles County (323) 442-9062

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 Gillenwater's NPI number?

The NPI number for Timothy Gillenwater is 1275763922. It was assigned to this individual provider in the NPPES registry on July 15, 2009.

Where is Timothy Gillenwater located?

Timothy Gillenwater practices at 1450 San Pablo St Ste 6200, Los Angeles, CA 90033. The listed phone number is (323) 442-7920.

What is Timothy Gillenwater's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Timothy Gillenwater enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Timothy Gillenwater was last updated on November 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.