Dr Timothy S Staacke, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Kenosha, Wisconsin. His current practice location is
10400 75th St, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 697-7000.
Dr Timothy S Staacke is licensed to practice in Wisconsin (license number 39495) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1457335523.
Physician's Profile
| Full Name | Dr Timothy S Staacke |
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| Gender | Male |
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| Speciality | |
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| Experience | Years |
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| Location | 10400 75th St, Kenosha, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Timothy S Staacke attended and graduated from in
NPI Data:
- NPI Number: 1457335523
- Provider Enumeration Date: 12/02/2005
- Last Update Date: 06/29/2022
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Timothy S Staacke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457335523 | NPI | - | NPPES |
| 32412100 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | 39495-020 (Wisconsin) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 39495 (Wisconsin) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 39495 (Wisconsin) | Primary |
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. Dr Timothy S Staacke 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 |
|---|
Dr Timothy S Staacke, MD
225 S Executive Dr,
Brookfield, WI 53005-4266
Ph: (262) 787-4026 | Dr Timothy S Staacke, MD
10400 75th St,
Kenosha, WI 53142-7884
Ph: (262) 697-7000 |
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