DR. TIMOTHY RAYMOND NIEDZIELAK DO
NPI 1972028421
Orthopaedic Surgery in Rockford, IL

Q: What is Timothy Niedzielak's NPI number?

The NPI number for Timothy Niedzielak is 1972028421. It was assigned to this individual provider in the NPPES registry on August 6, 2017.

Q: What is Timothy Niedzielak's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Active since August 06, 2017PECOS EnrolledAccepts Medicare Assignment

97.28/100

CMS Quality Rating

8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114(815) 971-7000(815) 968-7830 Get Directions Write a Review

NPPES record last updated: September 12, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 24, 2022, Jul 22, 2022, Feb 8, 2019 and 1 more (4 updates tracked since 2017).

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About Dr. Timothy Raymond Niedzielak Do NPPES

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

DR. TIMOTHY RAYMOND NIEDZIELAK DO (NPI 1972028421) is an individual orthopaedic surgery provider in Rockford, Illinois, licensed in Illinois (036165587) and active in the NPI registry since August 2017. He is enrolled in Medicare PECOS, is affiliated with Javon Bea Hospital, and maintains a secondary practice location in Columbia.

NPPES Registry Identity

NPI1972028421

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. TIMOTHY RAYMOND NIEDZIELAKCredential: DO

Location Address8201 E RIVERSIDE BLVDRockford, IL 61114-2300

Mailing Address8201 E Riverside BlvdRockford, IL 61114-2300 · (815) 971-7000 · Fax (815) 968-7830

Phone(815) 971-7000

Fax(815) 968-7830

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateAugust 6, 2017

Last NPPES UpdateSeptember 12, 20234 updates tracked since enumeration

NPPES CertifiedSeptember 12, 2023

✔ NPI 1972028421 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Licenses✔ Licensed in IL · 036165587✔ Licensed in FL · 5665✔ Licensed in MO · 2022018519

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedOrthopaedic Surgery · Orthopaedic TraumaTaxonomy 207XX0801X · License 2022018519 (MO)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 5665 (FL)

8201 E RIVERSIDE BLVD, Rockford, IL 61114

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Secondary Practice Location 1

Location 11100 Virginia AveColumbia, MO 65212-0001 · Phone (573) 882-2663 · Fax (573) 882-1760

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MercyCare, MercyCare Health Plans 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 Raymond Niedzielak Do 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 ID6103200951

PECOS Enrollment IDI20230919000937, I20251224001424

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

Medicare enrollment records show Timothy Niedzielak reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rockford Health Physicians

0.4 mi

Multi-Specialty

8201 E RIVERSIDE BLVD
Rockford, IL 61114

Reassigned Medicare billing, Illinois enrollment
1,375 clinicians in this Medicare group

NPI 1043242886 (608) 314-2428

Acute Care Surgery Of South Dakota PC

731 mi

Orthopaedic Surgery

1635 CAREGIVER CIR
Rapid City, SD 57702

Reassigned Medicare billing, South Dakota enrollment
87 clinicians in this Medicare group

NPI 1730797184 (916) 441-0400

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 3

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.

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.

50 services50 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.

14 services13 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Javon Bea Hospital

Acute Care Hospitals · Rockford, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140239

Location8201 E Riverside BlvdRockford, IL 61114 · Winnebago County

Emergency services Birthing friendly

Monument Health Rapid City Hospital

Acute Care Hospitals · Rapid City, SD

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number430077

Location353 Fairmont BlvdRapid City, SD 57701 · Pennington County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61114 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

97.28/100

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

Scored through an Alternative Payment Model

Quality

89.78

Promoting Interoperability

98.23

Improvement Activities

Other Providers at the Same Location NPPES 20

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

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