Timothy Wall, in Travis Afb, CA - Medicare Internal Medicine

Timothy Wall, is a medicare enrolled "Internal Medicine" physician in Travis Afb, California. His current practice location is 101 Bodin Cir, Travis Afb, California. You can reach out to his office (for appointments etc.) via phone at (707) 423-3000.

Timothy Wall is licensed to practice in California (license number A182748) 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 1659870939.

Contact Information

	Timothy Wall,
	101 Bodin Cir, Travis Afb, CA 94535-1809
	(707) 423-3000
	Not Available

Map and Direction

Physician's Profile

Full Name	Timothy Wall
Gender	Male
Speciality	Internal Medicine
Location	101 Bodin Cir, Travis Afb, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1659870939
Provider Enumeration Date: 02/01/2018
Last Update Date: 09/30/2024

Medicare PECOS Information:

PECOS PAC ID: 3779833553
Enrollment ID: I20230718001506

Medical Identifiers

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

Identifier	Type	State	Issuer
1659870939	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208M00000X	Hospitalist	A182748 (California)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
207R00000X	Internal Medicine	A182748 (California)	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 Wall allows following entities to bill medicare on his behalf.

Entity Name	John Muir Physician Network
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841407665 PECOS PAC ID: 6608789813 Enrollment ID: O20031226000143

Entity Name	Quantum Healthcare Medical Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568490597 PECOS PAC ID: 5294647574 Enrollment ID: O20040924000422

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 Wall 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 Wall, 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: () -	Timothy Wall, 101 Bodin Cir, Travis Afb, CA 94535-1809 Ph: (707) 423-3000

Reviews and Comments

Internal Medicine Doctors in Travis Afb, CA

Dr. Leena M Joshi, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-816-5930
Cherie J Renaud, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-2300
Joseph Cameron Sky, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-2300
Mark Derasmo, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-7342
David James Carlson, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-2300 Fax: 707-423-7496
Jacob Kjelland, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-5129
Dr. Samuel Farrell, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 101 Bodin Cir, Travis Afb, CA 94535 Phone: 707-423-3000

Timothy Wall, - Medicare Internal Medicine in Travis Afb, CA