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DR. TIMOTHY DONALD MACON D.O.,F.C.C.P.
NPI 1679561443
Internal Medicine - Pulmonary Disease in Sterling, MI

Active since October 06, 2005PECOS EnrolledAccepts Medicare Assignment
780 N GAVORD RD, STERLING, MI 48659(989) 654-2168(989) 654-2825 Get Directions Write a Review

NPPES record last updated: October 23, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Timothy Donald Macon D.o.,f.c.c.p. NPPES

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

DR. TIMOTHY DONALD MACON D.O.,F.C.C.P. (NPI 1679561443) is an individual pulmonary disease provider in Sterling, Michigan, licensed in Michigan (TM009037) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital, Troy, and is a graduate of Michigan State University College Of Osteopathic Medicine (1989).

NPPES Registry Identity

NPI1679561443
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. TIMOTHY DONALD MACONCredential: D.O.,F.C.C.P.
Location Address780 N GAVORD RDSterling, MI 48659-9703
Mailing Address780 N Gavord RdSterling, MI 48659-9703 · (989) 654-2168 · Fax (989) 654-2825
Phone(989) 654-2168
Fax(989) 654-2825
Sole ProprietorYes
Medical School CMSMichigan State University College Of Osteopathic MedicineGraduated 1989
Enumeration DateOctober 6, 2005
Last NPPES UpdateOctober 23, 2020
NPPES CertifiedOctober 23, 2020
✔ NPI 1679561443 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in MI · TM009037
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
780 N GAVORD RD, Sterling, MI 48659
Open in Google Maps ↗

Other Identifiers 13

Other383563124MI · United Health Plan
Medicaid4261168MI
Other1000781MA · Mclaren Health Advantage
Other110216075MI · Rail Road Medicare
Other122278MI · Preferred Choice
Other4509887MI · Aetna
Other115651012MI · Blue Cross Blue Shield
Other115651012MI · Blue Care Network
Other302002MA · Central Health Plan Of Mi
Other1007603MI · Mclaren Health Plan
Other383563124MI · United Health Care
Other383563124MI · Ppom
Other383563124101MI · Community Choice Of Mich

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Timothy Donald Macon D.o.,f.c.c.p. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638074289
PECOS Enrollment IDI20031205000317
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 Reassignments

3

Medicare enrollment records show Timothy Macon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pulmonary & Critical Care Associates PC
109 mi
Pulmonary Disease
50505 SCHOENHERR RD, SUITE 290
Shelby Twp, MI 48315
  • Reassigned Medicare billing, Michigan enrollment
  • 22 clinicians in this Medicare group
NPI 1598700932 (586) 314-0080
William Beaumont Hospital
114 mi
General Acute Care Hospital
4949 COOLIDGE HWY
Royal Oak, MI 48073
  • Reassigned Medicare billing, Michigan enrollment
  • 154 clinicians in this Medicare group
NPI 1083833875 (248) 655-5900
Beaumont Medical Group- Specialty Services
115 mi
Surgery
3601 W 13 MILE RD
Royal Oak, MI 48073
  • Reassigned Medicare billing, Michigan enrollment
  • 1,030 clinicians in this Medicare group
NPI 1578072906 (248) 898-5000

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

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
217 services181 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
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.
112 services105 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
51 services44 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
40 services38 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
29 services29 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
25 services24 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230269
Location44201 Dequindre RoadTroy, MI 48085 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48659 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 20

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
25 suppliers611 claims611 services$30.96 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
17 suppliers351 claims351 services$70.15 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
14 suppliers293 claims735 services$25.60 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
18 suppliers246 claims1,349 services$13.99 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
14 suppliers146 claims812 services$12.03 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
23 suppliers457 claims457 services$44.04 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

WEST BRANCH PULMONARY CLINIC PC
Specialist
780 N GAVORD RD
STERLING, MI 48659
Arenac County (989) 654-2168

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 Macon's NPI number?

The NPI number for Timothy Macon is 1679561443. It was assigned to this individual provider in the NPPES registry on October 6, 2005.

Where is Timothy Macon located?

Timothy Macon practices at 780 N Gavord Rd, Sterling, MI 48659. The listed phone number is (989) 654-2168.

What is Timothy Macon's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Timothy Macon enrolled in Medicare?

Yes. Timothy Macon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Timothy Macon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Macon reassigns Medicare benefits to 3 organizations: Pulmonary & Critical Care Associates PC (Shelby Twp, MI), William Beaumont Hospital (Royal Oak, MI) and Beaumont Medical Group- Specialty Services (Royal Oak, MI). Each 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 Macon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Timothy Macon accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Timothy Macon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Timothy Macon affiliated with any hospitals?

According to CMS data, Timothy Macon is affiliated with Beaumont Hospital, Troy.

When was this NPI record last updated?

The NPPES record for Timothy Macon was last updated on October 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.