Tim Gengembre, PA-C is a
Physician Assistant based in Elm Grove, Wisconsin. Tim Gengembre is licensed to practice in Wisconsin (license number 245-023) and his current practice location is
1650 Pilgrim Pkwy, Elm Grove, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(262) 366-8985.
NPI number for Tim Gengembre is 1831354075 and his current mailing address is 1650 Pilgrim Pkwy, Elm Grove, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1831354075.
Provider's Profile
| Full Name | Tim Gengembre |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 1650 Pilgrim Pkwy, Elm Grove, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1831354075
- Provider Enumeration Date: 07/28/2008
- Last Update Date: 04/17/2013
Medical Identifiers
Medical identifiers for Tim Gengembre such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831354075 | NPI | - | NPPES |
| 42908600 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 245-023 (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. Tim Gengembre is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tim Gengembre, PA-C
1650 Pilgrim Pkwy,
Elm Grove, WI 53122-1531
Ph: (262) 366-8985 | Tim Gengembre, PA-C
1650 Pilgrim Pkwy,
Elm Grove, WI 53122-1531
Ph: (262) 366-8985 |
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