Mr Timothy Wilson, MD in Santa Monica, CA

Mr Timothy Wilson, MD is a medicare enrolled "Urology" physician in Santa Monica, California. He went to Oregon Health Sciences University School Of Medicine and graduated in 1980 and has 44 years of diverse experience with area of expertise as Urology. He is a member of the group practice Providence Saint Johns Medical Foundation and his current practice location is 2121 Santa Monica Blvd, Santa Monica, California. You can reach out to his office (for appointments etc.) via phone at (310) 582-7137.

Mr Timothy Wilson is licensed to practice in California (license number G57490) 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 1912005422.

Contact Information

	Mr Timothy Wilson, MD
	2121 Santa Monica Blvd, Santa Monica, CA 90404-2303
	(310) 582-7137
	(310) 582-7140

Map and Direction

Physician's Profile

Full Name	Mr Timothy Wilson
Gender	Male
Speciality	Urology
Experience	44 Years
Location	2121 Santa Monica Blvd, Santa Monica, California
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Timothy Wilson attended and graduated from Oregon Health Sciences University School Of Medicine in 1980

NPI Data:

NPI Number: 1912005422
Provider Enumeration Date: 09/20/2006
Last Update Date: 09/14/2021

Medicare PECOS Information:

PECOS PAC ID: 6406861707
Enrollment ID: I20060207001043

Medical Identifiers

Medical identifiers for Mr Timothy Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912005422	NPI	-	NPPES
00G574900	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208800000X	Urology	G57490 (California)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Providence Saint John's Health Center	Santa monica, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Providence Saint Johns Medical Foundation	0840548624	273

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Timothy Wilson allows following entities to bill medicare on his behalf.

Entity Name	Providence Saint Johns Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518438712 PECOS PAC ID: 0840548624 Enrollment ID: O20180810000904

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. Mr Timothy Wilson 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
Mr Timothy Wilson, MD 1333 S Mayflower Ave, 2nd Floor, Monrovia, CA 91016-4066 Ph: (626) 775-3514	Mr Timothy Wilson, MD 2121 Santa Monica Blvd, Santa Monica, CA 90404-2303 Ph: (310) 582-7137

Reviews and Comments

Urology Doctors in Santa Monica, CA

Milton Krisiloff, MD Urology Medicare: Medicare Enrolled Practice Location: 2001 Santa Monica Blvd, Suite 1165 W, Santa Monica, CA 90404 Phone: 310-829-7766 Fax: 310-453-1031
Catherine C Gu, MD Urology Medicare: Medicare Enrolled Practice Location: 1260 15th St Ste 1200, Santa Monica, CA 90404 Phone: 310-794-7700
Mary Olubukola Fakunle, Urology Medicare: Medicare Enrolled Practice Location: 1260 15th St Ste 1200, Santa Monica, CA 90404 Phone: 310-794-7700
Mehran Movassaghi, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2001 Santa Monica Blvd Ste 460w, Santa Monica, CA 90404 Phone: 310-582-7333 Fax: 310-315-6157
Stanley Allen Brosman, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2021 Santa Monica Blvd, #510, Santa Monica, CA 90404 Phone: 310-828-8531 Fax: 310-829-1350
Jesse N Mills, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1260 15th St, Suite 1200, Santa Monica, CA 90404 Phone: 310-451-8751
Dr. Karyn S Eilber, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2020 Santa Monica Blvd., Suite 570, Santa Monica, CA 90404 Phone: 310-453-2061 Fax: 310-453-2161

Mr Timothy Wilson, MD - Medicare Urology in Santa Monica, CA