TIMOTHY M WALLACE MD
NPI 1720013121
Pathology - Anatomic Pathology & Clinical Pathology in Summit, WI

NPI Status: Active since July 12, 2006

Contact Information

36500 AURORA DR
SUMMIT, WI
ZIP 53066
Phone: (262) 434-3741
Fax: (262) 434-3702

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  • Individual
  • Male
  • Pathology
  • Anatomic Pathology & Clinical Pathology
  • Accepts Insurance
  • PECOS Enrolled

About TIMOTHY WALLACE

This page provides the complete NPI Profile along with additional information for Timothy Wallace, a provider established in Summit, Wisconsin with a medical specialization in Pathology, focusing in anatomic pathology & clinical pathology . The healthcare provider is registered in the NPI registry with number 1720013121 assigned on July 2006. The practitioner's primary taxonomy code is 207ZP0102X with license number 41030 (WI). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1720013121
Provider Name
TIMOTHY M WALLACE MD
Gender
Male
Entity Type
Individual
Location Address
36500 AURORA DR SUMMIT, WI 53066
Location Phone
(262) 434-3741
Location Fax
(262) 434-3702
Mailing Address
8901 W LINCOLN AVE WEST ALLIS, WI 53227
Mailing Phone
(414) 328-7950
Mailing Fax
(262) 434-3702
Is Sole Proprietor?
No
Enumeration Date
07-12-2006
Last Update Date
12-30-2021
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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

Pathology Anatomic Pathology & Clinical Pathology

Taxonomy Code
207ZP0102X
Type
Allopathic & Osteopathic Physicians
License No.
41030
License State
WI
Taxonomy Description
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Timothy Wallace 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

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Blood smear interpretation by physician with written report

Blood smear interpretation is a lab test where your doctor examines a sample of your blood under a microscope. They look for abnormalities in your blood cells which can help diagnose various conditions. You'll receive a written report of the findings.

This service was performed 14 times for 13 patients

Examination of archival tissue for genetic analysis

Examination of archival tissue for genetic analysis involves studying previously collected tissue samples. This process helps detect any genetic alterations that may be linked to certain diseases. It's a crucial step in understanding your health and planning appropriate treatments.

This service was performed 39 times for 39 patients

Microscopic genetic analysis of tumor, manual

Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.

This service was performed 68 times for 49 patients

Pathology examination of tissue using a microscope, high complexity

A high complexity pathology examination involves studying body tissue under a microscope to identify any abnormalities. This intricate process helps in diagnosing various conditions and deciding on the best treatment plan.

This service was performed 18 times for 17 patients

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 451 times for 278 patients

Pathology examination of tissue using a microscope, limited examination

A pathology examination of tissue using a microscope is a procedure where a small sample of your tissue is observed under a microscope. This limited examination helps identify any abnormal cells or signs of disease, aiding in accurate diagnosis and treatment planning.

This service was performed 14 times for 12 patients

Pathology examination of tissue using a microscope, moderately high complexity

A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.

This service was performed 75 times for 58 patients

Pathology examination of tissue using a microscope, moderately low complexity

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

This service was performed 60 times for 54 patients

Preparation of tissue for examination by removing any calcium present

This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.

This service was performed 20 times for 16 patients

Special stained specimen slides to examine tissue including interpretation and report

Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.

This service was performed 50 times for 13 patients

Special stained specimen slides to examine tissue, each additional procedure

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

This service was performed 229 times for 69 patients

Special stained specimen slides to examine tissue, each multiplex procedure

Special stained specimen slides are used to study tissue in detail. This multiplex procedure involves applying different dyes to the tissue sample on a slide to highlight specific elements. These colors help identify any abnormalities in the tissue, aiding in accurate diagnosis and treatment planning.

This service was performed 24 times for 17 patients

Special stained specimen slides to examine tissue, initial procedure

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

This service was performed 118 times for 110 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 35 times for 13 patients

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 53066 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 NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1720013121, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
2
Doubled → 4
Pos 4
0
Unchanged
Pos 5
0
Doubled → 0
Pos 6
1
Unchanged
Pos 7
3
Doubled → 6
Pos 8
1
Unchanged
Pos 9
2
Doubled → 4
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 3 → 6 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 4 + 0 + 0 + 1 + 6 + 1 + 4 + 24 = 49

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 49 is 50. The difference is the calculated check digit.

50 - 49 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1720013121.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Nurse Practitioner (Adult Health)
36500 AURORA DR
SUMMIT, WI 53066
Speech-Language Pathologist
36500 AURORA DR
SUMMIT, WI 53066
Specialist/Technologist (Athletic Trainer)
36500 AURORA DR
SUMMIT, WI 53066
Social Worker (Clinical)
36500 AURORA DR
SUMMIT, WI 53066
Family Medicine
36500 AURORA DR
SUMMIT, WI 53066
Physical Therapist
36500 AURORA DR
SUMMIT, WI 53066
Nurse Practitioner
36500 AURORA DR, SUITE 200
SUMMIT, WI 53066
Emergency Medicine
36500 AURORA DR
SUMMIT, WI 53066
Ophthalmology
36500 AURORA DR
SUMMIT, WI 53066
Anesthesiology
36500 AURORA DR
SUMMIT, WI 53066
Pharmacist
36500 AURORA DR, SUITE 100
SUMMIT, WI 53066
Speech-Language Pathologist
36500 AURORA DR
SUMMIT, WI 53066
Dietitian, Registered
36500 AURORA DR
SUMMIT, WI 53066
Dietitian, Registered
36500 AURORA DR
SUMMIT, WI 53066
Nurse Practitioner (Family)
36500 AURORA DR
SUMMIT, WI 53066
Physical Therapist
36500 AURORA DR
SUMMIT, WI 53066
Physical Therapist
36500 AURORA DR
SUMMIT, WI 53066
General Acute Care Hospital
36500 AURORA DR
SUMMIT, WI 53066
Occupational Therapist (Physical Rehabilitation)
36500 AURORA DR
SUMMIT, WI 53066
Physical Therapist
36500 AURORA DR
SUMMIT, WI 53066

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720013121, enumerated as an "individual" on July 12, 2006.

The provider is located at 36500 AURORA DR SUMMIT, WI 53066 and the phone number is (262) 434-3741.

Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.

The provider might be accepting Accepts: CareSource (Common Ground Healthcare). Please consult your insurance carrier or call the provider to verify.