Timothy Wallace Kaczmar, MD is a medicare enrolled "Family Medicine" physician in Eldridge, California. His current practice location is
15000 Arnold Dr, Eldridge, California. You can reach out to his office (for appointments etc.) via phone at
(707) 938-6000.
Timothy Wallace Kaczmar is licensed to practice in California (license number G68791) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1447244405.
Physician's Profile
Full Name | Timothy Wallace Kaczmar |
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Gender | Male |
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Speciality | Family Medicine |
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Location | 15000 Arnold Dr, Eldridge, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1447244405
- Provider Enumeration Date: 09/07/2005
- Last Update Date: 11/17/2016
Medicare PECOS Information:
- PECOS PAC ID: 5395041701
- Enrollment ID: I20160310002667
Medical Identifiers
Medical identifiers for Timothy Wallace Kaczmar such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1447244405 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | G68791 (California) | Primary |
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. Timothy Wallace Kaczmar allows following entities to bill medicare on his behalf.
Entity Name | State Of California - Department Of Developmental Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1154372498 PECOS PAC ID: 4082788732 Enrollment ID: O20081114000496 |
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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. Timothy Wallace Kaczmar 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 |
Timothy Wallace Kaczmar, MD 15000 Arnold Dr, Eldridge, CA 95431-8900 Ph: (707) 938-6000 | Timothy Wallace Kaczmar, MD 15000 Arnold Dr, Eldridge, CA 95431-8900 Ph: (707) 938-6000 |
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