Timothy M Wallace, MD - Medicare Pathology in Summit, WI

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Timothy M Wallace, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Summit, Wisconsin. His current practice location is 36500 Aurora Dr, Summit, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (262) 434-3741.

Timothy M Wallace is licensed to practice in Wisconsin (license number 41030) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720013121.

Contact Information

Timothy M Wallace, MD
36500 Aurora Dr,
Summit, WI 53066-4899
(262) 434-3741
(262) 434-3702

Map and Direction




Physician's Profile

Full NameTimothy M Wallace
GenderMale
SpecialityPathology - Anatomic Pathology & Clinical Pathology
Location36500 Aurora Dr, Summit, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1720013121
  • Provider Enumeration Date: 07/12/2006
  • Last Update Date: 12/30/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 5890769319
  • Enrollment ID: I20040820001121

Medical Identifiers

Medical identifiers for Timothy M Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1720013121NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207ZP0102XPathology - Anatomic Pathology & Clinical Pathology 41030 (Wisconsin)Primary

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. Timothy M Wallace allows following entities to bill medicare on his behalf.
Entity NameGreat Lakes Pathologists Sc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1689695934
PECOS PAC ID: 7315850682
Enrollment ID: O20031112000106

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. Timothy M Wallace 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 AddressPractice Location Address
Timothy M Wallace, MD
8901 W Lincoln Ave,
West Allis, WI 53227-2409

Ph: (414) 328-7950		Timothy M Wallace, MD
36500 Aurora Dr,
Summit, WI 53066-4899

Ph: (262) 434-3741

Reviews and Comments


Pathology Doctors in Summit, WI


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.