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TIMOTHY A VAN DYNE DPM INC
NPI 1962629824
Clinic/Center - Podiatric in Fresno, CA

Active since April 19, 2007
5777 N FRESNO ST, SUITE 102, FRESNO, CA 93710(559) 435-0261 Get Directions Write a Review

NPPES record last updated: February 24, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Timothy A Van Dyne Dpm Inc NPPES

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

TIMOTHY A VAN DYNE DPM INC (NPI 1962629824) is a healthcare organization registered as a podiatric in Fresno, California and active in the NPI registry since April 2007. The organization lists Timothy Allen Van Dyne, President, as its authorized official.

NPPES Registry Identity

NPI1962629824
Entity TypeOrganization
Primary Taxonomy261QP1100X
Legal Business NameTIMOTHY A VAN DYNE DPM INC
Location Address5777 N FRESNO ST, SUITE 102Fresno, CA 93710-6065
Mailing Address5777 N Fresno St, Suite 102Fresno, CA 93710-6065 · (559) 435-0261
Phone(559) 435-0261
Organization SubpartNo
Authorized OfficialTimothy Allen Van DynePresident · (559) 435-0261
Enumeration DateApril 19, 2007
Last NPPES UpdateFebruary 24, 2012
✔ NPI 1962629824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · PodiatricAmbulatory Health Care Facilities
Taxonomy Code261QP1100X
License✔ Licensed in CA · E2025
5777 N FRESNO ST, Fresno, CA 93710
Open in Google Maps ↗

Other Identifiers 1

OtherE2025CA · Medicare Id 000e20250

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy A Van Dyne Dpm Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateCaliforniaEnrollment IDO20120321000489Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Timothy A Van Dyne DPM Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Timothy Vandyne, DPM
Podiatry
NPI 1679579460
5777 N FRESNO ST SUITE 102
Fresno, CA 93710
(559) 435-0261
✔ PECOS✔ Accepts MedicareSame address

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

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 A Van Dyne Dpm Inc's NPI number?

The NPI number for Timothy A Van Dyne Dpm Inc is 1962629824. It was assigned to this organization in the NPPES registry on April 19, 2007.

Where is Timothy A Van Dyne Dpm Inc located?

Timothy A Van Dyne Dpm Inc is located at 5777 N Fresno St Suite 102, Fresno, CA 93710. The listed phone number is (559) 435-0261.

What is Timothy A Van Dyne Dpm Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Podiatric, with taxonomy code 261QP1100X.

Is Timothy A Van Dyne Dpm Inc enrolled in Medicare?

Yes. Timothy A Van Dyne Dpm Inc is registered in the Medicare PECOS enrollment system.

When is Timothy A Van Dyne Dpm Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Timothy A Van Dyne Dpm Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Timothy A Van Dyne Dpm Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Timothy A Van Dyne Dpm Inc was last updated on February 24, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.