DR. TIMOTHY MORRIS DEBLIECK (M.D.) – Family Medicine Physician, NPI 1114961042

DR. TIMOTHY MORRIS DEBLIECK (M.D.) is a healthcare provider. based in Boise, Idaho. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. M-7182 (ID). The NPI Number for DR. TIMOTHY MORRIS DEBLIECK (M.D.) is 1114961042

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
DR. TIMOTHY MORRIS DEBLIECK (M.D.)
NPI
1114961042
Phone
(208) 367-6030
Address
777 N RAYMOND ST
Enumeration Date
14 June 2006
Last Update Date
15 December 2023

Doctor Profile

Medical School Name
WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2085142500
Graduation Year
1990 (36 years ago)
PAC ID
8123113834
Group Practice PAC ID
6709986797
Professional Enrollment ID
I20070926000718
Address ID
ID837049251BO777XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

971 FAMILY PRACTICE in ID

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Provider Addresses for DR. TIMOTHY MORRIS DEBLIECK (M.D.)

  • 777, North Raymond Street, Boise Junction, Boise, Ada County, Idaho, 83704, United States

    BOISE, ID 837049251

    Phone: (208) 367-6030

    Fax: (208) 367-6123

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-09-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070926000718IFamily PracticeIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes1712$0
View full utilization report →

Insurance plans in this area (ZIP 83704)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709986797View full group profile
NameSpecialtyState
Family Practice, HospitalistID
Family PracticeID
-ID
-ID
-CA
Family PracticeID
Family PracticeID
Family PracticeID
Registered Dietitian Or Nutrition ProfessionalCA
Physician AssistantID

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do I look up DR. TIMOTHY MORRIS DEBLIECK (M.D.) by NPI?
Use NPI 1114961042 when you need to reference DR. TIMOTHY MORRIS DEBLIECK (M.D.) in forms, claims, or directories.
Does this profile mean DR. TIMOTHY MORRIS DEBLIECK (M.D.) is currently active?
Yes — DR. TIMOTHY MORRIS DEBLIECK (M.D.) appears active in the national provider directory.
Does DR. TIMOTHY MORRIS DEBLIECK (M.D.) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for DR. TIMOTHY MORRIS DEBLIECK (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. TIMOTHY MORRIS DEBLIECK (M.D.)?
The page summarizes Boise, Idaho for DR. TIMOTHY MORRIS DEBLIECK (M.D.); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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