Active NPI 1780679357 Individual Practitioner Male Practitioner

Dr. Timothy Dwight Edmisten , MD

Surgery • Boone, NC

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Timothy Edmisten, MD is a certified Surgery practicing in Boone, NC. With approximately 33 years of clinical experience since graduating from Brody School Of Medicine At East Carolina University in 1993, Dr. Edmisten delivers high-quality medical care to the local community at 965 STATE FARM RD.

Dr. Edmisten is affiliated with Appalachian Regional Medical Associates Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, biopsy of large bowel using an endoscope, follow-up hospital inpatient care per day. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

965 State Farm Rd

Boone, NC 286074948

Telephone 8282642340

Fax 8282620731

Associated Practice Facility / Clinic

🏢 Watauga Surgical Group Pa Facility NPI 1588653489

Medicare Profile & Education

Medical School

Brody School Of Medicine At East Carolina University

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Boone, NC

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

33 Yrs +3.5 yrs vs City Avg

City Avg: 29.5 Yrs

State Avg: 24.9 Yrs

Regional Practice Density

6 Specialists

Practicing in Boone, NC (1222 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

90.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Edmisten (33 Years) 33 Yrs

Boone Specialty Average (29.5 Years) 29.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	29	28	$196.00	$86.90
45380 Biopsy of large bowel using an endoscope	29	28	$1323.00	$122.15
99231 Follow-up hospital inpatient care per day, typically 15 minutes	28	16	$145.00	$47.15
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	24	24	$1174.00	$66.49
31623 Examination of lung airways using an endoscope	23	23	$787.00	$18.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$426.30	$159.27
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	21	17	$231.00	$75.41
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$275.71	$106.60
31625 Biopsy of lung airway using an endoscope	16	16	$999.00	$49.16
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$483.47	$124.58
31627 Computer-assisted image-guided navigation of lung airways using an endoscope	15	15	$4053.00	$90.15
31654 Examination of lung airways using an endoscope with imaging guidance and ultrasound	15	15	$346.40	$62.82
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	15	14	$3580.00	$206.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	14	$301.60	$122.84
31629 Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope	12	12	$1297.00	$109.13
31626 Placement of radiation therapy markers into lung airways using an endoscope	11	11	$2517.00	$108.99
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$491.27	$210.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	39	37	$159.44	$86.44
99231 Follow-up hospital inpatient care per day, typically 15 minutes	31	20	$92.16	$47.83
45380 Biopsy of large bowel using an endoscope	29	29	$775.55	$111.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	26	26	$364.38	$159.57
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	25	23	$322.76	$171.80
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	24	24	$452.33	$77.17
31623 Examination of lung airways using an endoscope	23	22	$434.43	$21.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	17	$241.47	$122.53
31625 Biopsy of lung airway using an endoscope	18	18	$536.78	$50.04
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	17	17	$319.41	$125.49
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	15	15	$740.33	$157.31
31627 Computer-assisted image-guided navigation of lung airways using an endoscope	14	14	$1569.64	$91.29
31654 Examination of lung airways using an endoscope with imaging guidance and ultrasound	13	13	$188.31	$63.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$245.31	$107.08
31629 Needle biopsy of windpipe cartilage, airway, and/or lung using an endoscope	11	11	$725.55	$104.57
31652 Exam of lung airways and sampling of lymph nodes using an endoscope and ultrasound guidance, 1-2 lymph nodes	11	11	$1313.09	$209.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	51	45	$150.00	$88.55
99231 Follow-up hospital inpatient care per day, typically 15 minutes	36	26	$82.00	$37.63
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	31	21	$150.00	$69.64
45380 Biopsy of large bowel using an endoscope	30	30	$441.00	$117.75
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	29	29	$303.22	$78.15
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	25	21	$297.00	$177.09
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$338.00	$163.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	16	$220.00	$125.02
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	17	17	$499.00	$128.20
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	16	16	$425.00	$216.31
31623 Examination of lung airways using an endoscope	16	15	$310.00	$0.64
36561 Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older	16	15	$714.00	$326.95
77001 Fluoroscopic guidance for insertion, replacement or removal of central venous access device	15	14	$38.00	$18.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$221.00	$109.51
76937 Ultrasonic guidance for blood vessel access	15	14	$34.00	$13.56
31625 Biopsy of lung airway using an endoscope	15	14	$359.00	$70.18
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$284.00	$131.94
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	12	12	$557.00	$234.82
31627 Computer-assisted image-guided navigation of lung airways using an endoscope	11	11	$190.00	$95.13
31624 Irrigation and suction of lung airways to obtain cells using an endoscope	11	11	$313.00	$36.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	42	37	$150.00	$89.64
45380 Biopsy of large bowel using an endoscope	39	39	$441.00	$100.14
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	38	24	$150.00	$70.62
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	37	37	$300.51	$61.89
99231 Follow-up hospital inpatient care per day, typically 15 minutes	36	27	$82.00	$37.77
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	27	23	$297.00	$178.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	24	$220.00	$127.43
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	23	23	$499.00	$153.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$221.00	$107.14
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	19	19	$557.00	$251.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$338.00	$165.26
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	16	16	$284.00	$133.56
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$210.00	$99.10
31623 Examination of lung airways using an endoscope	14	14	$310.00	$14.67
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	14	14	$425.00	$207.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	55	35	$80.07	$39.10
99213 Established patient office or other outpatient visit, typically 15 minutes	42	36	$146.07	$73.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	38	$214.97	$106.58
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	37	37	$301.40	$74.66
45380 Biopsy of large bowel using an endoscope	32	32	$474.72	$103.50
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	30	16	$146.90	$72.15
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	22	22	$486.52	$144.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$330.47	$161.72
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	20	20	$279.04	$137.05
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	17	17	$544.50	$256.85
99221 Initial hospital inpatient care per day, typically 30 minutes	15	14	$205.88	$101.14
31623 Examination of lung airways using an endoscope	14	14	$303.21	$24.79
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$292.04	$143.77

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	80	76	$141.46	$70.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	48	$209.38	$103.49
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	51	33	$141.62	$70.26
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	50	50	$499.47	$136.86
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	48	46	$292.05	$66.52
45380 Biopsy of large bowel using an endoscope	41	41	$420.12	$107.04
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	30	30	$528.58	$246.09
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$321.72	$157.15
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	21	21	$269.99	$132.07
31623 Examination of lung airways using an endoscope	19	19	$295.35	$38.39
46221 Removal of external hemorrhoids by rubber banding	18	14	$518.72	$259.31
99231 Follow-up hospital inpatient care per day, typically 15 minutes	17	13	$81.08	$38.00
99221 Initial hospital inpatient care per day, typically 30 minutes	16	15	$198.99	$97.53
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	14	14	$281.73	$139.28
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$144.21	$72.59
31625 Biopsy of lung airway using an endoscope	13	13	$340.58	$118.15
31654 Examination of lung airways using an endoscope with imaging guidance and ultrasound	11	11	$134.55	$66.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	78	43	$141.12	$70.44
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	68	68	$470.44	$163.26
99213 Established patient office or other outpatient visit, typically 15 minutes	65	59	$140.58	$68.69
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	65	64	$290.24	$76.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	51	$207.48	$98.40
45380 Biopsy of large bowel using an endoscope	31	31	$415.56	$92.78
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$318.64	$157.34
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	24	24	$524.90	$239.51
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	22	$267.70	$132.05
99221 Initial hospital inpatient care per day, typically 30 minutes	22	22	$197.88	$94.20
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	18	18	$207.82	$102.74
47563 Removal of gallbladder with x-ray study of bile ducts using an endoscope	16	16	$1448.03	$695.19
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	11	$279.88	$138.96
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$83.18	$41.90

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	250	199	$100.00	$69.69
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	114	101	$147.00	$102.09
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	99	49	$126.00	$69.83
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	84	84	$204.00	$156.74
45384 Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery	50	50	$1152.80	$152.85
43239 Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope	50	50	$971.88	$71.90
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	42	42	$143.00	$102.79
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	29	28	$234.00	$132.19
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	28	18	$72.00	$41.38
45380 Biopsy of large bowel using an endoscope	22	22	$1054.73	$107.53
45385 Removal of polyps or growths of large bowel using an endoscope with mechanical snare	22	21	$1706.00	$252.80
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	11	$205.00	$138.60
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$174.00	$97.70

Medical Specialties & State Licenses

CMS Verified: 2023-03-10

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NC 9800856

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Surgery - Vascular Surgery

NUCC Taxonomy Code: 2086S0129X

State License NC 9800856

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Thoracic Surgery (Cardiothoracic Vascular Surgery)

NUCC Taxonomy Code: 208G00000X

State License NC 9800856

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

891227R (NC)

Hospital & Practice Group Affiliations

Appalachian Regional Medical Associates Inc

965 State Farm Rd, Boone, NC 286074948

Phone: 8282642340

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Dr. Anne-Corinne Beaver , MD

Surgery

NPI 1356445761

Doctor of Medicine (M.D.)

Tonya Williamson-Leon , PA

Physician Assistant

NPI 1417126566

Physician Assistant

Matthew Lutz , PA-C

Physician Assistant

NPI 1417465550

Physician Assistant (Certified)

Dr. Paul Dagher , MD

Surgery

NPI 1871588434

Doctor of Medicine (M.D.)

Emily Moore , PA-C

Physician Assistant

NPI 1972836948

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

👤

Provider Name / Credentials Updated March 10, 2023

Recorded as TIMOTHY EDMISTEN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 10, 2023

Surgery (License #9800856 in NC)

✅

NPI Profile Active August 01, 2013

NPI status registered as active in NPPES database

📍

Updated Practice Location August 01, 2013

Registered at 965 STATE FARM RD, BOONE, NC 286074948 (Tel: 8282642340)

📍

Updated Business Mailing Address August 01, 2013

Registered at 965 STATE FARM RD, BOONE, NC 286074948 (Tel: 8282642340)

👤

Provider Name / Credentials Updated August 01, 2013

Recorded as TIM EDMISTEN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2013

Surgery (License #9800856 in NC)

🟢

Initial NPI Registration & Enumeration September 20, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780679357

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 20, 2005

Last Update: March 10, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

965 State Farm Rd

Boone, NC 286074948

Phone: 8282642340

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.