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TIMOTHY J MAHONEY MD NPI 1689608192


NPI Information

NPI: 1689608192
Provider Name: TIMOTHY J MAHONEY, MD
Classification: Surgery - 208600000X
Entity Type: Individual
Organization: LAKE REGION HEALTHCARE CORPORATION

PECOS Registration: Yes

Address:
1707 GOLD DR S STE 101
FARGO, ND
ZIP 58103
Phone: (701) 280-2033
Get Directions

Timothy J Mahoney, MD is a surgery in Fargo, ND with 50 years of experience. The provider is 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. Timothy J Mahoney, MD NPI is 1689608192. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1974

The provider's business location address is:

1707 GOLD DR S STE 101
FARGO, ND
ZIP 58103-413
Phone: (701) 280-2033
Fax: (701) 232-5578

The NPI 1689608192 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 9/19/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgery3622NORTH DAKOTAYes
2208600000XSurgery24007MINNESOTANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11700559OTHERNORTH DAKOTAMEDICA #
2120231OTHERNORTH DAKOTAUCARE #
32164OTHERNORTH DAKOTANDBS #
4844548OTHERNORTH DAKOTAAMERICA'S PPO/ARAZ #
5020001354MEDICARE ID-TYPE UNSPECIFIEDNORTH DAKOTAMN MEDICARE #
613390MEDICAIDNORTH DAKOTA
76508OTHERNORTH DAKOTASIOUX VALLEY #
8ND20017469OTHERNORTH DAKOTALHS #
9020017469MEDICARE ID-TYPE UNSPECIFIEDNORTH DAKOTARR MEDICARE #
106508MEDICARE ID-TYPE UNSPECIFIEDNORTH DAKOTAND MEDICARE #
11DA9011008232OTHERNORTH DAKOTAPREFERRED ONE #
121700509OTHERNORTH DAKOTAMEDICA #
1320698OTHERNORTH DAKOTANDBS #
142164MEDICARE ID-TYPE UNSPECIFIEDNORTH DAKOTAND MEDICARE #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.