DR. TIMOTHY WILLIAM DWYER (M.D.) – Pediatric Sports Medicine Physician, NPI 1255312294

DR. TIMOTHY WILLIAM DWYER (M.D.) is a healthcare provider. based in Woodbridge, Virginia. specializing in Pediatric Sports Medicine Physician. They hold the professional credentials M.D.. They hold a License No. 155505 (MA). The NPI Number for DR. TIMOTHY WILLIAM DWYER (M.D.) is 1255312294

Main info

Male
Name
DR. TIMOTHY WILLIAM DWYER (M.D.)
NPI
1255312294
Phone
(619) 865-6624
Address
3108 WOODS COVE LN
Enumeration Date
8 November 2005
Last Update Date
29 November 2021

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

Provider Addresses for DR. TIMOTHY WILLIAM DWYER (M.D.)

  • 3108, Woods Cove Lane, Woodbridge, Prince William County, Virginia, 22192, United States

    WOODBRIDGE, VA 221921137

    Phone: (619) 865-6624

    Type: Mailing

  • NAVAL HEALTH CLINIC QUANTICO

    3259 CATLIN AVE

    QUANTICO, VA 22134

    Phone: (703) 784-5541

    Type: Location

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: 2009-01-06

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
I20090106000411IPediatric MedicineCATBD

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

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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 22192)

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Reviews

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Frequently asked questions

Does DR. TIMOTHY WILLIAM DWYER (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. TIMOTHY WILLIAM DWYER (M.D.) uses 1255312294.
Can I rely on DR. TIMOTHY WILLIAM DWYER (M.D.) being an active provider?
As of the registry snapshot, DR. TIMOTHY WILLIAM DWYER (M.D.) is marked active.
What taxonomy line describes DR. TIMOTHY WILLIAM DWYER (M.D.)?
For research purposes, treat DR. TIMOTHY WILLIAM DWYER (M.D.) as Pediatric Sports Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is DR. TIMOTHY WILLIAM DWYER (M.D.) based?
DR. TIMOTHY WILLIAM DWYER (M.D.) is tied to Woodbridge, Virginia in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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