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SHANTI TIMILSINA MD
NPI 1669051736
Internal Medicine in Two Rivers, WI

Active since April 06, 2021PECOS EnrolledAccepts Medicare Assignment
5000 MEMORIAL DR, TWO RIVERS, WI 54241(920) 794-5000 Get Directions Write a Review

NPPES record last updated: September 10, 2024. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Sep 10, 2024, Aug 7, 2024, May 5, 2021 and 1 more (4 updates tracked since 2021).

About Shanti Timilsina Md NPPES

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

SHANTI TIMILSINA MD (NPI 1669051736) is an individual internal medicine provider in Two Rivers, Wisconsin, licensed in Wisconsin (8206320) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, is affiliated with Aurora Baycare Medical Ctr, and maintains a secondary practice location in Green Bay.

NPPES Registry Identity

NPI1669051736
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSHANTI TIMILSINACredential: MD
Location Address5000 MEMORIAL DRTwo Rivers, WI 54241-3900
Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250
Phone(920) 794-5000
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 6, 2021
Last NPPES UpdateSeptember 10, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 10, 2024
✔ NPI 1669051736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 8206320
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
5000 MEMORIAL DR, Two Rivers, WI 54241
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Secondary Practice Location 1

Location 12845 Greenbrier Rd Ste 120Green Bay, WI 54311-6519 · Phone (920) 288-8100

Other Identifiers 1

Medicaid100246503WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and more.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

Shanti Timilsina Md 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 ID5991241911
PECOS Enrollment IDI20240725002190
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

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.
33 services25 patients

Hospital Affiliations CMS Care Compare

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

Aurora Baycare Medical Ctr

Acute Care Hospitals · Green Bay, WI
5/5 CMS rating
OwnershipProprietary
CMS Certification Number520193
Location2845 Greenbrier RdGreen Bay, WI 54311 · Brown County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54241 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MATTHEW KLEIN
Physical Therapist (Orthopedic)
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5000
MR. JOHN D DUSENBERY CRNA
Nurse Anesthetist, Certified Registered
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5000
ANGELIA VUE
Speech-Language Pathologist
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5376
DR. DAVID DEAN COPP M.D.
Surgery
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5000
EMIL M PAJEK M.D.
Internal Medicine
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5125
NICOLE H SODDY PT
Physical Therapist
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5000
DR. CHARLES D PRATT MD
Surgery
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5125
SUSAN LAURA PRIBYL C.O.T.A.
Occupational Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI 54241
Manitowoc County (920) 794-5176

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 Shanti Timilsina's NPI number?

The NPI number for Shanti Timilsina is 1669051736. It was assigned to this individual provider in the NPPES registry on April 6, 2021.

Where is Shanti Timilsina located?

Shanti Timilsina practices at 5000 Memorial Dr, Two Rivers, WI 54241. The listed phone number is (920) 794-5000.

What is Shanti Timilsina's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Shanti Timilsina enrolled in Medicare?

Yes. Shanti Timilsina 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 Shanti Timilsina accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners, Quartz and UnitedHealthcare list Shanti Timilsina 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 Shanti Timilsina affiliated with any hospitals?

According to CMS data, Shanti Timilsina is affiliated with Aurora Baycare Medical Ctr.

When was this NPI record last updated?

The NPPES record for Shanti Timilsina was last updated on September 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.