Timothy William Allen, MD
Individual provider Active NPI Family Medicine Physician · Cudahy, WI
NPI 1720007271 · NPPES record last updated Mar 21, 2020
Key facts
- NPI
- 1720007271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 45304-020 (WI)
- Practice address
- 4580 S Nicholson Ave
Cudahy, WI 53110-1360 - Phone
- (414) 326-4800
- Fax
- (855) 270-4751
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Milwaukee Medical College, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Advantage Physical Therapy and Sports Rehab, LLC
Independent Physicians of Wisconsin LLC
Allen Family Medicine SC
Practice addresses (Care Compare)
3503 E Layton Ave
Unit 100
Cudahy, WI 53110-1408
Phone (414) 489-0270
4580 S Nicholson Ave
Cudahy, WI 53110-1360
Phone (414) 326-4800
Hospital & facility affiliations
- Aurora at Home
- Aurora St Lukes Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040709001407 | WI | Practitioner - Family Practice | 0941288559 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45304-020 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independent Physicians of Wisconsin, LLC | Family Medicine | Current |
Accepting new patients |
| Allen Family Medicine SC | Family Medicine | Current |
Accepting new patients |
| Independent Physicians of Wisconsin, LLC | Current |
Accepting new patients |
Locations
4580 S Nicholson Ave
Cudahy, WI 53110
Phone (414) 326-4800
5434 W Capitol Dr
Ste 3
Milwaukee, WI 53216
Phone (414) 217-1229
Interoperability endpoints
- https://api.platform.athenahealth.com/18758/brand/1/csg/1/fhir/r4
- timothy.allen.1@18758.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 45304-020 | WI | |
| Family Medicine Physician | 207Q00000X | 45304-020 | WI | Yes |
Addresses
Primary practice location
4580 S Nicholson Ave
Cudahy, WI 53110-1360
Mailing address
4580 S Nicholson Ave
Cudahy, WI 53110-1360
Phone (414) 326-4800
Other providers in Cudahy, WI
- Mary Oluwakemi Akande
- Fatima Ali
- Margarite Allar
- Allen Family Medicine SC
- Nikki Allen
- Anne M Allmann
- Jaclyn Alvarado
- Nicholas N Armstrong
- Aurora Health Care Metro, Inc
- Aurora Health Care Metro, Inc.
All providers in Cudahy, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.