Timothy R Wallace, DO in Oshkosh, WI - Medicare Family Practice

Timothy R Wallace, DO is a medicare enrolled "Family Medicine" physician in Oshkosh, Wisconsin. He graduated from medical school in 2004 and has 21 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Aamg Reach Pllc, Aurora Medical Group, Inc. and his current practice location is 855 N Westhaven Dr, Oshkosh, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 303-8700.

Timothy R Wallace is licensed to practice in Wisconsin (license number 60032) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1275725384.

Contact Information

	Timothy R Wallace, DO
	855 N Westhaven Dr, Oshkosh, WI 54904-7668
	(920) 303-8700
	(920) 303-8832

Map and Direction

Physician's Profile

Full Name	Timothy R Wallace
Gender	Male
Speciality	Family Practice
Experience	21 Years
Location	855 N Westhaven Dr, Oshkosh, Wisconsin
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Timothy R Wallace graduated from medical school in 2004

NPI Data:

NPI Number: 1275725384
Provider Enumeration Date: 08/13/2007
Last Update Date: 04/09/2025

Medicare PECOS Information:

PECOS PAC ID: 2466545637
Enrollment ID: I20130613000405

Medical Identifiers

Medical identifiers for Timothy R Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275725384	NPI	-	NPPES
100028993	Medicaid	WI
1195	Other	SC	MEDICAL LICENSE
OS013436	Other	PA	LICENSE
011953	Medicaid	SC
60032-021	Other	WI	MEDICAL LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	OS013436 (Pennsylvania)	Secondary
207Q00000X	Family Medicine	1195 (South Carolina)	Secondary
207Q00000X	Family Medicine	60032 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Aurora Medical Ctr Oshkosh	Oshkosh, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Aamg Reach Pllc	5597133264	54
Aurora Medical Group, Inc.	6709794258	3491

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 R Wallace allows following entities to bill medicare on his behalf.

Entity Name	Aurora Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725

Entity Name	Aamg Reach Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609502707 PECOS PAC ID: 5597133264 Enrollment ID: O20221216002458

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 R 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 Address	Practice Location Address
Timothy R Wallace, DO Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250	Timothy R Wallace, DO 855 N Westhaven Dr, Oshkosh, WI 54904-7668 Ph: (920) 303-8700

Reviews and Comments

Family Medicine Doctors in Oshkosh, WI

Eric A Smiltneek, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 414 Doctors Ct, Oshkosh, WI 54901 Phone: 920-303-5100
Alexey Shereshevsky, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 600 N. Westhaven Drive, Thedacare Physicians Oshkosh, Oshkosh, WI 54904 Phone: 920-237-5000 Fax: 920-237-5001
Michael Menard, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700
Harold W Boccheciamp, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2725 Jackson St, Oshkosh, WI 54901 Phone: 920-223-7500
James W Smrecek, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1855 S Koeller St, Oshkosh, WI 54902 Phone: 920-223-7300
Dr. Scott J Beougher, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5165 Chesapeake Ct, Oshkosh, WI 54901 Phone: 920-303-2254
Karl C Larson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2725 Jackson St, Oshkosh, WI 54901 Phone: 920-223-7500 Fax: 920-223-7630

Timothy R Wallace, DO - Medicare Family Practice in Oshkosh, WI