DR. TIMOTHY WAYNE CAPPS M.D.
NPI 1801025135
Surgery in Elizabeth City, NC

Q: What is Timothy Capps's NPI number?

The NPI number for Timothy Capps is 1801025135. It was assigned to this individual provider in the NPPES registry on July 8, 2009.

Q: What is Timothy Capps's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Timothy Capps was last updated on April 23, 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.

Active since July 08, 2009PECOS EnrolledAccepts Medicare Assignment

95.11/100

CMS Quality Rating

1177 N ROAD ST, ELIZABETH CITY, NC 27909(252) 337-9440(252) 384-9997 Get Directions Write a Review

NPPES record last updated: April 23, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 23, 2021, Jun 28, 2016 (2 updates tracked since 2016).

On this page

About Dr. Timothy Wayne Capps M.d. NPPES

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

DR. TIMOTHY WAYNE CAPPS M.D. (NPI 1801025135) is an individual surgery provider in Elizabeth City, North Carolina, licensed in North Carolina (2015-00935) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Sentara Albemarle Medical Center, and maintains a secondary practice location in Edenton.

NPPES Registry Identity

NPI1801025135

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. TIMOTHY WAYNE CAPPSCredential: M.D.

Location Address1177 N ROAD STElizabeth City, NC 27909-3388

Mailing Address1177 N Road StElizabeth City, NC 27909-3388 · (252) 337-9440 · Fax (252) 384-9997

Phone(252) 337-9440

Fax(252) 384-9997

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2009

Enumeration DateJuly 8, 2009

Last NPPES UpdateApril 23, 20212 updates tracked since enumeration

NPPES CertifiedApril 23, 2021

✔ NPI 1801025135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in NC · 2015-00935

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.

1177 N ROAD ST, Elizabeth City, NC 27909

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Secondary Practice Location 1

Location 1203 Earnhart Dr, Suite BEdenton, NC 27932-8401 · Phone (252) 482-5868

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, 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 Wayne Capps M.d. 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 ID1557675089

PECOS Enrollment IDI20150728006049

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 Capps reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Albemarle Physician Services - Sentara, Inc

Same address

Surgery

1177 N ROAD ST
Elizabeth City, NC 27909

Reassigned Medicare billing, North Carolina enrollment
176 clinicians in this Medicare group

NPI 1962719609 (252) 337-9440

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 14

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.

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.

65 services47 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.

62 services61 patients

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.

58 services41 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

42 services30 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.

41 services34 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

39 services36 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

37 services37 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

27 services27 patients

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.

25 services25 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

24 services24 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

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.

20 services20 patients

Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery 45384

This procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.

14 services14 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

Sentara Albemarle Medical Center

Acute Care Hospitals · Elizabeth City, NC

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number340109

Location1144 N Road StElizabeth City, NC 27909 · Pasquotank County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27909 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.

95.11/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.31

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 7

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

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