TIMOTHY LELAND HERRICK (MD) – Family Medicine Physician, NPI 1063697159

TIMOTHY LELAND HERRICK (MD) is a healthcare provider. based in Portland, Oregon. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. MD15700 (OR). The NPI Number for TIMOTHY LELAND HERRICK (MD) is 1063697159

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY LELAND HERRICK (MD)
NPI
1063697159
Phone
(503) 494-8573
Address
3303 SW BOND AVE
Enumeration Date
8 January 2008
Last Update Date
27 March 2013

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
5034183900
Graduation Year
1983 (43 years ago)
PAC ID
3779734769
Group Practice PAC ID
1759328842
Professional Enrollment ID
I20121126000251
Address ID
OR972021643PO3930XSTXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

2,081 FAMILY PRACTICE in OR

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Provider Addresses for TIMOTHY LELAND HERRICK (MD)

  • OHSU Center For Health And Healing, 3303, Southwest Bond Avenue, South Portland, Portland, Metro, Multnomah County, Oregon, 97239, United States

    OHSU DEPARTMENT OF FAMILY MEDICINE

    PORTLAND, OR 972394501

    Phone: (503) 494-8573

    Fax: (503) 346-6961

    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: 2012-11-26

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
I20121126000251IFamily PracticeORTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 97239)

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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: 1759328842View full group profile

Reviews

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

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Frequently asked questions

What NPI should I save for TIMOTHY LELAND HERRICK (MD)?
Save NPI 1063697159 if you need a stable reference for TIMOTHY LELAND HERRICK (MD).
Is TIMOTHY LELAND HERRICK (MD) active in the national directory?
TIMOTHY LELAND HERRICK (MD)'s public NPI profile is in an active state.
Can you summarize TIMOTHY LELAND HERRICK (MD)'s specialty in plain language?
Clinically, the directory lists TIMOTHY LELAND HERRICK (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for TIMOTHY LELAND HERRICK (MD)?
The page summarizes Portland, Oregon for TIMOTHY LELAND HERRICK (MD); expand the address list for detail.
Is TIMOTHY LELAND HERRICK (MD) a real provider?
This page reflects official NPPES data for NPI 1063697159. Always confirm identity and privileges with the practice and licensing boards.

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