Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy James Immonen, DO

Individual provider Obstetrics & Gynecology Physician · NPI 1730614793

Timothy James Immonen, DO is an Obstetrics/Gynecology in Fort Worth, Texas. Graduated from Edward via Col of Osteo Medicine-Virginia Campus in 2017, 9 years ago. Practices with Acclaim Physician Group Inc, a 523-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan and Ohio.

Years since qualifying
9
Trained at
Edward via Col of Osteo Medicine-Virginia Campus
Licensed in
MI, OH
In the registry since
2017
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 702-1100
Fax: (817) 702-2140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 535 Nw 9th St, Oklahoma City, OK 73102-1070 — (405) 272-8498

Specialties & licences

Maternal & Fetal Medicine Physician (primary) Taxonomy 207VM0101X · Licence 5101027095 (MI)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 34.015859 (OH)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1730614793
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 27, 2017
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024
Mailing addressPo Box 732973, Dallas, TX 75373-6901

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolEDWARD VIA COL OF OSTEO MEDICINE-VIRGINIA CAMPUS
Graduated 2017 (9 years in practice)
Group practice Acclaim Physician Group Inc — 523 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fort Worth