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DR. TIMOTHY D BONNIWELL DMD
NPI 1386622173
Dentist - Oral and Maxillofacial Surgery in Ithaca, NY

Active since January 03, 2006Opted out of Medicare · through Jan 3, 2027
2377 N TRIPHAMMER RD, ITHACA, NY 14850(607) 266-8600(607) 266-8603 Get Directions Write a Review

NPPES record last updated: September 22, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Timothy D Bonniwell Dmd NPPES

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

DR. TIMOTHY D BONNIWELL DMD (NPI 1386622173) is an individual oral and maxillofacial surgery provider in Ithaca, New York, licensed in New York (053673-1) and active in the NPI registry since January 2006. He has opted out of Medicare through January 3, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1386622173
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. TIMOTHY D BONNIWELLCredential: DMD
Location Address2377 N TRIPHAMMER RDIthaca, NY 14850-1050
Mailing Address2377 N Triphammer RdIthaca, NY 14850-1050 · (607) 266-8600 · Fax (607) 266-8603
Phone(607) 266-8600
Fax(607) 266-8603
Sole ProprietorNo
Enumeration DateJanuary 3, 2006
Last NPPES UpdateSeptember 22, 2014
✔ NPI 1386622173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in NY · 053673-1
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2377 N TRIPHAMMER RD, Ithaca, NY 14850
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Dr. Timothy D Bonniwell Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 3, 2013 through January 3, 2027.

Opt-Out Effective DateJanuary 3, 2013
Opt-Out In Effect ThroughJanuary 3, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14850 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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.

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 Bonniwell's NPI number?

The NPI number for Timothy Bonniwell is 1386622173. It was assigned to this individual provider in the NPPES registry on January 3, 2006.

Where is Timothy Bonniwell located?

Timothy Bonniwell practices at 2377 N Triphammer Rd, Ithaca, NY 14850. The listed phone number is (607) 266-8600.

What is Timothy Bonniwell's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Timothy Bonniwell enrolled in Medicare?

No. Timothy Bonniwell has opted out of Medicare through January 3, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Timothy Bonniwell was last updated on September 22, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.