Timothy Matthew Race, MSN, CRNP, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Plymouth, Pennsylvania. His current practice location is
142 Davenport St, Plymouth, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(570) 899-1871.
Timothy Matthew Race is licensed to practice in Pennsylvania (license number SP028392) 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 1083486625.
Provider's Profile
Full Name | Timothy Matthew Race |
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Gender | Male |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 142 Davenport St, Plymouth, Pennsylvania |
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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: 1083486625
- Provider Enumeration Date: 10/26/2023
- Last Update Date: 12/04/2023
Medicare PECOS Information:
- PECOS PAC ID: 0345699815
- Enrollment ID: I20231208001601
Medical Identifiers
Medical identifiers for Timothy Matthew Race such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083486625 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | SP028392 (Pennsylvania) | 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. Timothy Matthew Race allows following entities to bill medicare on his behalf.
Entity Name | Supportive Care Of Pennsylvania Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1174992275 PECOS PAC ID: 0143521211 Enrollment ID: O20151214002225 |
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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. Timothy Matthew Race 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 |
Timothy Matthew Race, MSN, CRNP, PMHNP-BC 142 Davenport St, Plymouth, PA 18651-1604 Ph: () - | Timothy Matthew Race, MSN, CRNP, PMHNP-BC 142 Davenport St, Plymouth, PA 18651-1604 Ph: (570) 899-1871 |
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