Dr Timothy S Staacke, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Kenosha, Wisconsin. He went to University Of Wisconsin School Of Medicine and graduated in 1993 and has 31 years of diverse experience with area of expertise as Anesthesiology. He is a member of the group practice Aurora Medical Group, Inc. and his current practice location is
10400 75th St, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 697-7000.
Dr Timothy S Staacke is licensed to practice in Wisconsin (license number 39495) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1457335523.
Physician's Profile
| Full Name | Dr Timothy S Staacke |
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| Gender | Male |
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| Speciality | Anesthesiology |
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| Experience | 31 Years |
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| Location | 10400 75th St, Kenosha, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Timothy S Staacke attended and graduated from University Of Wisconsin School Of Medicine in 1993
NPI Data:
- NPI Number: 1457335523
- Provider Enumeration Date: 12/02/2005
- Last Update Date: 06/29/2022
Medicare PECOS Information:
- PECOS PAC ID: 9638165251
- Enrollment ID: I20040421000307
Medical Identifiers
Medical identifiers for Dr Timothy S Staacke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457335523 | NPI | - | NPPES |
| 32412100 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207L00000X | Anesthesiology | 39495-020 (Wisconsin) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 39495 (Wisconsin) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 39495 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Aurora Medical Group, Inc. | 6709794258 | 3207 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Timothy S Staacke allows following entities to bill medicare on his behalf.
| Entity Name | Aurora Medical Group, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427271378
PECOS PAC ID: 6709794258
Enrollment ID: O20031105000725 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Timothy S Staacke is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Timothy S Staacke, MD
225 S Executive Dr,
Brookfield, WI 53005-4266
Ph: (262) 787-4026 | Dr Timothy S Staacke, MD
10400 75th St,
Kenosha, WI 53142-7884
Ph: (262) 697-7000 |
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