SHANTI TIMILSINA MD
NPI 1669051736
Internal Medicine in Two Rivers, WI
NPI Status: Active since April 06, 2021
Contact Information
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
Phone: (920) 794-5000
- Individual
- Female
- Internal Medicine
- Accepts Insurance
- PECOS Enrolled
About SHANTI TIMILSINA
This page provides the complete NPI Profile along with additional information for Shanti Timilsina, an internist established in Two Rivers, Wisconsin with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1669051736 assigned on April 2021. The practitioner's primary taxonomy code is 207R00000X with license number 8206320 (WI). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1669051736
- Provider Name
- SHANTI TIMILSINA MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 5000 MEMORIAL DR TWO RIVERS, WI 54241
- Location Phone
- (920) 794-5000
- Mailing Address
- PO BOX 735044 CHICAGO, IL 60673
- Mailing Phone
- (800) 326-2250
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-06-2021
- Last Update Date
- 09-10-2024
- Code Navigator
An internist like Shanti Timilsina is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- 2845 Greenbrier Rd Ste 120
Green Bay, WI 54311
(920) 288-8100
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 8206320
- License State
- WI
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value HSA (No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Value+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100246503 | MEDICAID (05) | WI |
Medicare Participation & PECOS Enrollment Status
Shanti Timilsina is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 54241 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $123.69
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $30.92
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.41
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $23.85
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 6 | 9 | 0 | 5 | 1 | 7 | 3 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 12 | 9 | 0 | 5 | 2 | 7 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 2 + 9 + 0 + 5 + 2 + 7 + 6 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1669051736 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
MR. JOHN D DUSENBERY CRNA
Nurse Anesthetist, Certified Registered
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
MICHAEL JOHN HEIDT LAT
Specialist/Technologist
(Athletic Trainer)
5000 MEMORIAL DR
REHABILITATION DEPARTMENT
TWO RIVERS, WI
ZIP 54241
RICHARD DAVIS CRNA
Nurse Anesthetist, Certified Registered
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
VALERIE JEAN SHEPPERD MS, CCC-SLP
Speech-Language Pathologist
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
JACLYN KARBON PTA
Physical Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
CHRISTINE RUTH CLARK COTA
Occupational Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
DARCY VARONA RN
Registered Nurse
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
KAREN A. SCHULTZ M.S.P.T.
Physical Therapist
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
JOY LYNN PRESTON PTA
Physical Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
THERESA MARIE PRUCHA O.T.R. C.H.T.
Occupational Therapist
(Hand)
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
ANN MARY VANDENHOUTEN PTA
Physical Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
KAREN ANN NOVY OTR
Occupational Therapist
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
MRS. JACQUELINE ANN KINJERSKI COTA
Occupational Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
SUSAN LAURA PRIBYL C.O.T.A.
Occupational Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
MISS ROBERTA ANN VINCENT OTR
Occupational Therapist
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
MS. KJERSTIN K OHNSTAD
Physical Therapist
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
SHEILA KAYE OLSON
Occupational Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
SUSAN E SACHSE MOT, OTR
Occupational Therapist
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
MICHAEL J RADEMACHER COTA
Occupational Therapy Assistant
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
MEGAN BRUEGGE PT
Physical Therapist
5000 MEMORIAL DR
TWO RIVERS, WI
ZIP 54241
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1669051736, enumerated as an "individual" on April 06, 2021.
The provider is located at 5000 MEMORIAL DR TWO RIVERS, WI 54241 and the phone number is (920) 794-5000.
Internal Medicine with taxonomy code 207R00000X.
The provider might be accepting Accepts: UnitedHealthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
