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TIMOTHY J ULRICH MD
NPI 1619263563
Pediatrics - Neonatal-Perinatal Medicine in Coeur D Alene, ID

Active since June 20, 2011PECOS Enrolled
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814(208) 625-5187(208) 625-6892 Get Directions Write a Review

NPPES record last updated: May 5, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 5, 2021, Jun 22, 2017 (2 updates tracked since 2017).

About Timothy J Ulrich Md NPPES

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

TIMOTHY J ULRICH MD (NPI 1619263563) is an individual neonatal-perinatal medicine provider in Coeur D Alene, Idaho, licensed in Idaho (M-13706) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619263563
Entity TypeIndividualMale
Primary Taxonomy2080N0001X
Provider Legal NameTIMOTHY J ULRICHCredential: MD
Location Address2003 KOOTENAI HEALTH WAYCoeur D Alene, ID 83814-6051
Mailing Address2003 Kootenai Health WayCoeur D Alene, ID 83814-6051 · (208) 625-5187 · Fax (208) 625-6892
Phone(208) 625-5187
Fax(208) 625-6892
Sole ProprietorNo
Enumeration DateJune 20, 2011
Last NPPES UpdateMay 5, 20212 updates tracked since enumeration
NPPES CertifiedMay 5, 2021
✔ NPI 1619263563 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080N0001X
License✔ Licensed in ID · M-13706
Definition
A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.
2003 KOOTENAI HEALTH WAY, Coeur D Alene, ID 83814
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy J Ulrich Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Timothy Ulrich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Luke's Clinic LLC
370 mi
Family Medicine
775 POLE LINE RD W
Twin Falls, ID 83301
  • Reassigned Medicare billing, Idaho enrollment
  • Medicare enrollment name: St Lukes Clinic LLC
  • 322 clinicians in this Medicare group
NPI 1790718229 (208) 814-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

CHRISTINA CRABTREE M.D.
Emergency Medicine
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
SCOTT GEYER RD
Dietitian, Registered
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
DR. MATTHEW KUNZ DO
Emergency Medicine
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
MRS. AMANDA K KAMPF RN, BSN
Student in an Organized Health Care Education/Training Program
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
DR. PATRICK WILLIAM MAGAJNA MD
Emergency Medicine
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
JOSHUA LEPPERT CRNA
Nurse Anesthetist, Certified Registered
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 765-8585
MARC OLAV GRANRUD
Hospitalist
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6900
KIMBERLEY S HALL DIETICIAN
Dietitian, Registered
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 666-2000

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 Ulrich's NPI number?

The NPI number for Timothy Ulrich is 1619263563. It was assigned to this individual provider in the NPPES registry on June 20, 2011.

Where is Timothy Ulrich located?

Timothy Ulrich practices at 2003 Kootenai Health Way, Coeur D Alene, ID 83814. The listed phone number is (208) 625-5187.

What is Timothy Ulrich's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Is Timothy Ulrich enrolled in Medicare?

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

Which organization bills Medicare for Timothy Ulrich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Ulrich reassigns Medicare benefits to St Luke's Clinic LLC (Twin Falls, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Ulrich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Timothy Ulrich was last updated on May 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.