Timothy Wall

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A182748 Issued in CA

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(707) 423-3000

NPI assigned

Feb 1, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Hospitalist

Education

Baylor College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
• John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496
• Contra Costa Regional Medical Center Hospital, Martinez, CA, CCN 050276

Merit-based Incentive Payment System (MIPS)

Final score

90.32 of 100Reported as group

Quality

89.54

Promoting interoperability

100

Improvement activities

40

Cost

74.34

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twall176128@ehr.johnmuirhealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• John Muir Physician Network

  • General Practice Physician
  • Walnut Creek, CA
  • NPI 1841407665
  Medicare reassignment Care Compare group NPD
• Quantum Healthcare Medical Associates Inc.

  • Hospitalist Physician
  • Colton, CA
  • NPI 1568490597

  Internal Medicine

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  Care Compare affiliation
• John Muir Health

  • General Acute Care Hospital
  • Walnut Creek, CA
  • NPI 1740215219
  Care Compare affiliation
• John Muir Health

  • General Acute Care Hospital
  • Concord, CA
  • NPI 1801821376
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1659870939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Grant St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945202270",
            "country_code": "US",
            "telephone_number": "925-947-3393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-01",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A182748",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A182748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Wagonlander, OTR/L, CHT
• Tirzah Wende Prince Wait, MD
• Alana Leigh Waiwaiole
• Rinky Jasmin Walia, M.D.
• Dylan Douglas Walker, MD
• Alec Nathaniel Wallace, DO
• James Franklin Walroth, M.D.
• Martin William Walsh, DDS
• Abraham Wang, PA-C
• Yangli Wang

• Internal Medicine Physician in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.