TIMOTHY DWIGHT EDMISTEN MD
NPI 1780679357
Surgery in Boone, NC

Active since September 20, 2005PECOS EnrolledAccepts Medicare Assignment
93.24/100
CMS Quality Rating
965 STATE FARM RD, BOONE, NC 28607(828) 264-2340(828) 262-0731 Get Directions Write a Review

NPPES record last updated: March 10, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Timothy Dwight Edmisten Md NPPES

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

TIMOTHY DWIGHT EDMISTEN MD (NPI 1780679357) is an individual surgery provider in Boone, North Carolina, licensed in North Carolina (9800856) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Watauga Medical Center, and is a graduate of Brody School Of Medicine At East Carolina University (1993).

NPPES Registry Identity

NPI1780679357
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameTIMOTHY DWIGHT EDMISTENCredential: MD
Location Address965 STATE FARM RDBoone, NC 28607-4948
Mailing Address965 State Farm RdBoone, NC 28607-4948 · (828) 264-2340 · Fax (828) 262-0731
Fax(828) 262-0731
Sole ProprietorYes
Medical School CMSBrody School Of Medicine At East Carolina UniversityGraduated 1993
Enumeration DateSeptember 20, 2005
Last NPPES UpdateMarch 10, 2023
NPPES CertifiedMarch 10, 2023
NPI 1780679357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License Licensed in NC · 9800856
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X · License 9800856 (NC)
Also ListedThoracic Surgery (Cardiothoracic Vascular Surgery)Taxonomy 208G00000X · License 9800856 (NC)
965 STATE FARM RD, Boone, NC 28607

Other Identifiers 1

Medicaid891227RNC

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Timothy Dwight Edmisten Md 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 ID6103910419
PECOS Enrollment IDI20100719000369
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.

Areas of Expertise CMS Part B claims 17

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.

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
29 services28 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.
29 services28 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
28 services16 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
24 services24 patients
Exam of lung airways using an endoscope 31623
This procedure, known as a bronchoscopy, involves a doctor examining your lung airways with a thin tube called an endoscope. It helps detect any issues in your lungs or airways, such as infections or blockages. It's a safe, routine procedure.
23 services23 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.
23 services23 patients

Hospital Affiliations CMS Care Compare 2

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

Watauga Medical Center

Acute Care Hospitals · Boone, NC
3/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number340051
Location336 Deerfield RoadBoone, NC 28607 · Watauga County
Emergency services Birthing friendly

Charles A Cannon Jr Memorial Hospital

Critical Access Hospitals · Linville, NC
OwnershipVoluntary non-profit - Private
CMS Certification Number341323
Location434 Hospital DriveLinville, NC 28646 · Avery County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28607 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
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.24/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality83.24
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 9

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

Surgery
965 STATE FARM RD
BOONE, NC 28607
Surgery
965 STATE FARM RD
BOONE, NC 28607
Surgery
965 STATE FARM RD
BOONE, NC 28607
Physician Assistant
965 STATE FARM RD
BOONE, NC 28607
Physician Assistant
965 STATE FARM RD
BOONE, NC 28607
Surgery
965 STATE FARM RD
BOONE, NC 28607
Nurse Practitioner (Family)
965 STATE FARM RD
BOONE, NC 28607
Surgery
965 STATE FARM RD
BOONE, NC 28607

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 Edmisten's NPI number?

The NPI number for Timothy Edmisten is 1780679357. It was assigned to this individual provider in the NPPES registry on September 20, 2005.

Where is Timothy Edmisten located?

Timothy Edmisten practices at 965 State Farm Rd, Boone, NC 28607. The listed phone number is (828) 264-2340.

What is Timothy Edmisten's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Timothy Edmisten enrolled in Medicare?

Yes. Timothy Edmisten 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.

What insurance does Timothy Edmisten accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Timothy Edmisten 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 Edmisten affiliated with any hospitals?

According to CMS data, Timothy Edmisten is affiliated with Watauga Medical Center and Charles A Cannon Jr Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Timothy Edmisten was last updated on March 10, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.