MR. TIMOTHY L. WEIDE (P.A.) – Physician Assistant, NPI 1861600017

MR. TIMOTHY L. WEIDE (P.A.) is a healthcare provider. based in Douglass, Kansas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 1500761 (KS). The NPI Number for MR. TIMOTHY L. WEIDE (P.A.) is 1861600017

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
MR. TIMOTHY L. WEIDE (P.A.)
NPI
1861600017
Phone
Not provided
Address
22120 SW WILLIAMS RD
Enumeration Date
20 May 2007
Last Update Date
1 February 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3167883376
Graduation Year
2000 (26 years ago)
PAC ID
1355314808
Group Practice PAC ID
2567511132
Professional Enrollment ID
I20040817000266
Address ID
KS670373667DE1121XSTXX501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,303 PHYSICIAN ASSISTANT in KS

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Provider Addresses for MR. TIMOTHY L. WEIDE (P.A.)

  • 22120 SW WILLIAMS RD

    DOUGLASS, KS 670398539

    Phone:

    Type: Mailing

  • Park Street, Castleward, Pride Park, Derby, East Midlands, England, DE1 2NB, United Kingdom

    SUITE # 400

    DERBY, KS 670373665

    Phone: (316) 788-3376

    Fax: (316) 788-3378

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $121.

Total Amount is formed as General ($121) + Research ($0) + Ownership ($0) = $121.

Last reported payment date: 2024-05-24 • Largest payer in this snapshot: Janssen Biotech, Inc. ($100).

Total Amount

$121

General + Research + Ownership

Payments

2

Total payment records

General Amount

$121

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-08-17

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
I20040817000266IPhysician AssistantKSTBD

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
17003Destruction of precancer skin growth, 2-14 growths44881$0
99212Established patient office or other outpatient visit, 10-19 minutes184124$0
17110Destruction of skin growth, 1-14 growths171126$0
17000Destruction of precancer skin growth, 1 growth166124$0
99213Established patient office or other outpatient visit, 20-29 minutes146101$0
View full utilization report →

Insurance plans in this area (ZIP 67039)

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Provider's Procedures

MR. TIMOTHY L. WEIDE (P.A.) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTKS17003Destruction of 2-14 skin growths33070

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: 2567511132View full group profile
NameSpecialtyState
Nurse PractitionerKS

Reviews

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Frequently asked questions

How do payers reference MR. TIMOTHY L. WEIDE (P.A.)?
For MR. TIMOTHY L. WEIDE (P.A.), use NPI 1861600017 as the unique 10-digit identifier.
Is there an active status for MR. TIMOTHY L. WEIDE (P.A.)?
For scheduling context, MR. TIMOTHY L. WEIDE (P.A.) is shown as active in the registry.
What expertise is attributed to MR. TIMOTHY L. WEIDE (P.A.)?
MR. TIMOTHY L. WEIDE (P.A.)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
Is MR. TIMOTHY L. WEIDE (P.A.) associated with Douglass?
Public fields place MR. TIMOTHY L. WEIDE (P.A.) around Douglass, Kansas. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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