TIM B GANNON P.A.
NPI 1780992024
Physician Assistant - Medical in Santa Fe, NM
NPI Status: Active since September 21, 2010
Contact Information
649 HARKLE RD STE E
SANTA FE, NM
ZIP 87505
Phone: (505) 955-9454
Fax: (505) 216-9067
- Individual
- Male
- Physician Assistant
- Medical
- Accepts Insurance
- PECOS Enrolled
About TIM GANNON
This page provides the complete NPI Profile along with additional information for Tim Gannon, a primary care provider established in Santa Fe, New Mexico with a medical specialization in Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1780992024 assigned on September 2010. The practitioner's primary taxonomy code is 363AM0700X with license number PA2010-0058 (NM). The provider is registered as an individual and his NPI record was last updated March 2026.
- NPI
- 1780992024
- Provider Name
- TIM B GANNON P.A.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 649 HARKLE RD STE E SANTA FE, NM 87505
- Location Phone
- (505) 955-9454
- Location Fax
- (505) 216-9067
- Mailing Address
- PO BOX 6880 SANTA FE, NM 87502
- Mailing Phone
- (505) 955-9454
- Mailing Fax
- (505) 216-9067
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-21-2010
- Last Update Date
- 03-26-2026
- Code Navigator
A primary care provider (PCP) like Tim Gannon sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA2010-0058
- License State
- NM
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AZ Blue ACA StandardHealth Silver with Health Choice - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard+ (Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 25773119 | MEDICAID (05) | NM |
Medicare Participation & PECOS Enrollment Status
Tim Gannon is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for TIM B GANNON P.A.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1780992024, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 66 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SANTA FE, NM 87505
SANTA FE, NM 87505
SANTA FE, NM 87505
SANTA FE, NM 87505
SANTA FE, NM 87505
SANTA FE, NM 87505
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780992024, enumerated as an "individual" on September 21, 2010.
The provider is located at 649 HARKLE RD STE E SANTA FE, NM 87505 and the phone number is (505) 955-9454.
Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.
The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona,. Please consult your insurance carrier or call the provider to verify.
