DR. TIMOTHY M PEASAK (NPI# 1720142391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720142391 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY M PEASAK |
| Credential | D.O. |
| Practice Address |
1370 Johnson Ave 1st Floor Bridgeport WV 26330 |
| Practice Telephone | 3048423330 |
| Practice Fax Number | 3048423303 |
| Mailing Telephone | 3048423330 |
| Mailing Fax Number | 3048423303 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2016-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 1942 | WV | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 34.008542 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
1370 JOHNSON AVE 1ST FLOOR |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619946936 | James J Demarco | Internal Medicine | 1370 Johnson Ave, Ste 203, Bridgeport, WV 26330-1378 | 2006-03-17 |
| 1962036509 | Maria Bridgette Scudere | Nurse Practitioner | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2020-02-22 |
| 1841663127 | Carrie Renee Arbogast | Physician Assistant | 1370 Johnson Ave, Ste 102, Bridgeport, WV 26330-1492 | 2015-11-09 |
| 1750674149 | Tammy Lou Yazevac | Physician Assistant | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2011-05-18 |
| 1740508779 | Raetta Lynn Wentz | Physician Assistant | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2010-05-14 |
| 1023332699 | Jaclyn K Swick | Physician Assistant | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2010-03-25 |
| 1750565800 | United Hospital Center, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1370 Johnson Ave, Suite 201, Bridgeport, WV 26330-1492 | 2007-12-26 |
| 1578692679 | Medbrook Medical Assoc. Inc. | Clinical Medical Laboratory | 1370 Johnson Ave, Bridgeport, WV 26330-1382 | 2007-03-05 |
| 1649292228 | Medbrook Medical Associates Inc | Pharmacy | 1370 Johnson Ave, Bridgeport, WV 26330-1492 | 2006-07-24 |
| 1922065879 | Carol A Shirey | Internal Medicine | 1370 Johnson Ave, Ste 102, Bridgeport, WV 26330-1492 | 2006-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578126009 | Michaela Colleen Anderson | Emergency Medicine | 25 Dewhirst St, Bridgeport, CT 06606-4042 | 2019-04-19 |
| 1316227838 | Medexpress Urgent Care, Inc. - West Virginia | Emergency Medicine | 120 Medical Park Drive, Suite 100, Bridgeport, WV 26330 | 2011-08-29 |
| 1629175898 | Citcads, PC | Emergency Medicine | 39 Asia Cir, Bridgeport, CT 06610-1262 | 2006-09-20 |
| 1326024555 | Harry Marinakis | Emergency Medicine | 49 E Wexford Way, Bridgeport, WV 26330 | 2005-12-20 |
| 1003437633 | Jessica Lynn Carder | Emergency Medicine | 327 Medical Park Dr, Bridgeport, WV 26330-9006 | 2020-05-05 |
| 1255865275 | Brandon M Lewko | Emergency Medicine | 527 Medical Park Dr, Suite 500, Bridgeport, WV 26330-9008 | 2017-04-17 |
| 1770932725 | Kelly R Patel | Emergency Medicine | 2800 Main St, Bridgeport, CT 06606-4201 | 2016-06-10 |
| 1902254220 | Nicholas Michael Chill | Emergency Medicine | 327 Medical Park Dr, Bridgeport, WV 26330-9006 | 2016-05-26 |
| 1962857649 | Jessica Aviles | Emergency Medicine | 2800 Main St, Bridgeport, CT 06606-4292 | 2016-04-29 |
| 1992168975 | Henna Kaur Kochar | Emergency Medicine | 267 Grant St, Bridgeport, CT 06610-2805 | 2016-03-29 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.