Dr Timothy A Diller, MD is a medicare enrolled "Surgery" physician in Jacksonville, Arkansas. His current practice location is
1400 Braden St, Emergency Dept, Jacksonville, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(501) 985-7000.
Dr Timothy A Diller is licensed to practice in Michigan (license number 4301044283) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1205899481.
Physician's Profile
Full Name | Dr Timothy A Diller |
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Gender | Male |
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Speciality | Surgery |
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Location | 1400 Braden St, Jacksonville, Arkansas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205899481
- Provider Enumeration Date: 04/10/2006
- Last Update Date: 06/19/2012
Medicare PECOS Information:
- PECOS PAC ID: 9234236761
- Enrollment ID: I20120627000730
Medical Identifiers
Medical identifiers for Dr Timothy A Diller such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205899481 | NPI | - | NPPES |
786546 | Other | AR | HEALTHLINK |
P01027351 | Other | | RAILROAD MCARD |
07100015600 | Other | AR | QC |
5086184 | Other | AR | AETNA |
164478001 | Medicaid | AR | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 4301044283 (Michigan) | Primary |
2086S0129X | Surgery - Vascular Surgery | T2007-006 (Arkansas) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Timothy A Diller allows following entities to bill medicare on his behalf.
Entity Name | Pere Marquette Emergency Physicians Plc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1447284112 PECOS PAC ID: 1052356094 Enrollment ID: O20050621000913 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Timothy A Diller is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Timothy A Diller, MD Po Box 3925, Shreveport, LA 71133-3925 Ph: (800) 684-0052 | Dr Timothy A Diller, MD 1400 Braden St, Emergency Dept, Jacksonville, AR 72076-3721 Ph: (501) 985-7000 |
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