DR. TIMOTHY DAVID LOGAN (D.O.) – Cardiovascular Disease Physician, NPI 1477763779

DR. TIMOTHY DAVID LOGAN (D.O.) is a healthcare provider. based in Mount clemens, Michigan. specializing in CARDIOVASCULAR DISEASE (CARDIOLOGY), INTERVENTIONAL CARDIOLOGY. They hold the professional credentials D.O.. They hold a License No. 5101015334 (MI). The NPI Number for DR. TIMOTHY DAVID LOGAN (D.O.) is 1477763779

Main info

Male
Sole Proprietor
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. TIMOTHY DAVID LOGAN (D.O.)
NPI
1477763779
Phone
(586) 493-8000
Address
1000 HARRINGTON ST
Enumeration Date
23 May 2007
Last Update Date
2 September 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2486259099
Graduation Year
2002 (24 years ago)
PAC ID
0840383840
Group Practice PAC ID
3971416082
Professional Enrollment ID
I20070907000143
Address ID
MI483271970WA5210XRDXX303
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

1,221 CARDIOVASCULAR DISEASE (CARDIOLOGY) in MI

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Provider Addresses for DR. TIMOTHY DAVID LOGAN (D.O.)

  • McLaren Macomb, 1000, Harrington Street, Mount Clemens, Clinton Township, Macomb County, Michigan, 48043, United States

    MOUNT CLEMENS, MI 480432920

    Phone: (586) 493-8000

    Type: Location

  • 21608, Englehardt Street, Saint Clair Shores, Macomb County, Michigan, 48080, United States

    SAINT CLAIR SHORES, MI 480802928

    Phone: (586) 218-4088

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 178 Open Payments records for all available years, with a total value of $12,457.

Total Amount is formed as General ($12,457) + Research ($0) + Ownership ($0) = $12,457.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: E.R. Squibb & Sons, L.L.C. ($6,950).

Total Amount

$12,457

General + Research + Ownership

Payments

178

Total payment records

General Amount

$12,457

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

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: 2007-09-07

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
I20070907000143ICardiovascular Disease (Cardiology)MITBD

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
99214Established patient office or other outpatient visit, 30-39 minutes439310$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only430346$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes273108$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes9685$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes7244$0
View full utilization report →

Insurance plans in this area (ZIP 48043)

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Provider's Procedures

DR. TIMOTHY DAVID LOGAN (D.O.) performs procedures in CARDIOVASCULAR DISEASE (CARDIOLOGY). See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERVENTIONAL CARDIOLOGYMI78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies4444
INTERVENTIONAL CARDIOLOGYMI93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report206121
INTERVENTIONAL CARDIOLOGYMI93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart4141

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: 3971416082View full group profile
NameSpecialtyState
Internal MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Family PracticeMI
Emergency MedicineIL
-GA
Emergency MedicineMI
Emergency MedicineMI
Physician AssistantMI
-MI

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Frequently asked questions

What identifier follows DR. TIMOTHY DAVID LOGAN (D.O.) across health systems?
The NPI 1477763779 uniquely identifies DR. TIMOTHY DAVID LOGAN (D.O.) in U.S. healthcare data.
Is DR. TIMOTHY DAVID LOGAN (D.O.)'s NPI status active today?
Active status means DR. TIMOTHY DAVID LOGAN (D.O.)'s NPI record is not deactivated in the public file.
Which specialty label fits DR. TIMOTHY DAVID LOGAN (D.O.)?
NPPES ties DR. TIMOTHY DAVID LOGAN (D.O.) to Cardiovascular Disease Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit DR. TIMOTHY DAVID LOGAN (D.O.) in Mount Clemens, Michigan?
For routing, start with Mount Clemens, Michigan for DR. TIMOTHY DAVID LOGAN (D.O.), then verify phone and hours locally.
Who maintains DR. TIMOTHY DAVID LOGAN (D.O.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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