DR. TIMOTHY MARTIN REISENAUER (PH.D.) – Psychologist, NPI 1407032063

DR. TIMOTHY MARTIN REISENAUER (PH.D.) is a healthcare provider. based in Mill creek, Washington. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 1287 (WA). The NPI Number for DR. TIMOTHY MARTIN REISENAUER (PH.D.) is 1407032063

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
DR. TIMOTHY MARTIN REISENAUER (PH.D.)
NPI
1407032063
Phone
Not provided
Address
15418 MAIN ST UNIT 301
Enumeration Date
14 January 2008
Last Update Date
14 January 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4258706166
Graduation Year
1987 (39 years ago)
PAC ID
3072507995
Professional Enrollment ID
I20040414000339
Address ID
WA982011507EV1022XAVEX300
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

775 CLINICAL PSYCHOLOGIST in WA

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Provider Addresses for DR. TIMOTHY MARTIN REISENAUER (PH.D.)

  • 301, Κωνσταντινουπόλεως, Community of Acharnes, Municipal Unit of Acharnes, Municipality of Acharnes, Regional Unit of East Attica, Attica, 16371, Greece

    MILL CREEK, WA 980129031

    Phone:

    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: 2004-04-14

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
I20040414000339IClinical PsychologistWATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98012)

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Reviews

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Frequently asked questions

Can I use this page to confirm DR. TIMOTHY MARTIN REISENAUER (PH.D.)'s NPI?
Yes. DR. TIMOTHY MARTIN REISENAUER (PH.D.) is listed with NPI 1407032063 in the public NPI dataset.
Is DR. TIMOTHY MARTIN REISENAUER (PH.D.) listed as active for patients and plans?
The listing shows DR. TIMOTHY MARTIN REISENAUER (PH.D.) as active in the NPI system.
What is DR. TIMOTHY MARTIN REISENAUER (PH.D.) best known for clinically?
Directory data describes DR. TIMOTHY MARTIN REISENAUER (PH.D.) with Psychologist. Clinical services aligned with this taxonomy classification.
Where should I expect DR. TIMOTHY MARTIN REISENAUER (PH.D.) on a map?
Expect Mill Creek, Washington as a primary anchor for DR. TIMOTHY MARTIN REISENAUER (PH.D.) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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