TIMOTHY MICHAEL WHEELER M.D.
NPI 1609822816
Surgery in Ashland, KY

Active since May 26, 2006PECOS EnrolledAccepts Medicare Assignment
82.94/100
CMS Quality Rating
613 23RD ST STE 440, ASHLAND, KY 41101(606) 329-2888(606) 329-2890 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jul 15, 2017 (2 updates tracked since 2017).

About Timothy Michael Wheeler M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY MICHAEL WHEELER M.D. (NPI 1609822816) is an individual surgery provider in Ashland, Kentucky, licensed in Kentucky (36483) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with King's Daughters' Medical Center, and is a graduate of University Of Louisville School Of Medicine (1994).

NPPES Registry Identity

NPI1609822816
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameTIMOTHY MICHAEL WHEELERCredential: M.D.
Location Address613 23RD ST STE 440Ashland, KY 41101-2885
Mailing AddressPo Box 2379Ashland, KY 41105-2379 · (606) 408-6200 · Fax (606) 408-6612
Fax(606) 329-2890
Sole ProprietorNo
Medical School CMSUniversity Of Louisville School Of MedicineGraduated 1994
Enumeration DateMay 26, 2006
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
NPI 1609822816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License Licensed in KY · 36483
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
613 23RD ST STE 440, Ashland, KY 41101

Other Identifiers 3

Medicaid1805837000WV
Medicaid2228379OH
Medicaid64028103KY

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Timothy Michael Wheeler M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618880972
PECOS Enrollment IDI20110228000452
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
68 services43 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
61 services38 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
55 services55 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
43 services42 patients
Removal of gallbladder using an endoscope 47562
This procedure, known as endoscopic gallbladder removal, involves a surgeon using a special tool called an endoscope to remove your gallbladder through small incisions. It's typically done to treat gallstones and related complications. It's a less invasive method, often leading to quicker recovery.
35 services35 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
31 services28 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

King's Daughters' Medical Center

Acute Care Hospitals · Ashland, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180009
Location2201 Lexington AvenueAshland, KY 41101 · Boyd County
Emergency services

Three Rivers Medical Center

Acute Care Hospitals · Louisa, KY
3/5 CMS rating
OwnershipProprietary
CMS Certification Number180128
Location2485 Highway 644Louisa, KY 41230 · Lawrence County
Emergency services

Kings Daughters Medical Center Ohio

Acute Care Hospitals · Portsmouth, OH
OwnershipVoluntary non-profit - Private
CMS Certification Number360361
Location1901 Argonne RoadPortsmouth, OH 45662 · Scioto County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 41101 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

82.94/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality70.01
Promoting Interoperability100
Improvement Activities40
Cost65.57

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Gastroenterology)
613 23RD ST STE 440
ASHLAND, KY 41101
Nurse Practitioner (Family)
613 23RD ST STE 440
ASHLAND, KY 41101
Surgery
613 23RD ST STE 440
ASHLAND, KY 41101
Nurse Practitioner (Family)
613 23RD ST STE 440
ASHLAND, KY 41101
Surgery
613 23RD ST STE 440
ASHLAND, KY 41101
Nurse Practitioner (Family)
613 23RD ST STE 440
ASHLAND, KY 41101
Physician Assistant
613 23RD ST STE 440
ASHLAND, KY 41101
Internal Medicine (Gastroenterology)
613 23RD ST STE 440
ASHLAND, KY 41101

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Wheeler's NPI number?

The NPI number for Timothy Wheeler is 1609822816. It was assigned to this individual provider in the NPPES registry on May 26, 2006.

Where is Timothy Wheeler located?

Timothy Wheeler practices at 613 23rd St Ste 440, Ashland, KY 41101. The listed phone number is (606) 329-2888.

What is Timothy Wheeler's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Timothy Wheeler enrolled in Medicare?

Yes. Timothy Wheeler is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Timothy Wheeler accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Molina Healthcare list Timothy Wheeler as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Timothy Wheeler affiliated with any hospitals?

According to CMS data, Timothy Wheeler is affiliated with King's Daughters' Medical Center, Three Rivers Medical Center and Kings Daughters Medical Center Ohio.

When was this NPI record last updated?

The NPPES record for Timothy Wheeler was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.