Dr Timothy Allen Clem, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Brooklyn Park, Minnesota. His current practice location is
10000 Zane Ave N, Brooklyn Park, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(763) 572-5700.
Dr Timothy Allen Clem is licensed to practice in Nebraska (license number 1312) 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 1558705871.
Physician's Profile
| Full Name | Dr Timothy Allen Clem |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology |
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| Location | 10000 Zane Ave N, Brooklyn Park, Minnesota |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1558705871
- Provider Enumeration Date: 04/18/2013
- Last Update Date: 09/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 5092011270
- Enrollment ID: I20231003001722
Medical Identifiers
Medical identifiers for Dr Timothy Allen Clem such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1558705871 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 1312 (Nebraska) | Primary |
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 Allen Clem allows following entities to bill medicare on his behalf.
| Entity Name | Fairview Health Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013994359
PECOS PAC ID: 1951213057
Enrollment ID: O20031105000461 |
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| Entity Name | Fairview Clinics |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346432218
PECOS PAC ID: 7113830142
Enrollment ID: O20031106000516 |
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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 Allen Clem 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 |
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Dr Timothy Allen Clem, DO
Unit 33100,
Apo, AE 09180-3100
Ph: (314) 590-6985 | Dr Timothy Allen Clem, DO
10000 Zane Ave N,
Brooklyn Park, MN 55443-1400
Ph: (763) 572-5700 |
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