DR. TIMOTHY S STAACKE M.D. NPI 1457335523

NPI Information

  • NPI: 1457335523
  • Provider Name: DR. TIMOTHY S STAACKE, M.D.
  • Classification: Pain Medicine - 208VP0014X
  • Specialization: Interventional Pain Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 10400 75TH ST
    KENOSHA, WI
    ZIP 53142
  • Phone: (262) 697-7000

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NPI Details

DR. Timothy S Staacke, M.D. is an interventional pain medicine pain medicine in Kenosha, WI with 33 years of experience. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. DR. Timothy S Staacke, M.D. NPI is 1457335523. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduation Year:1993

The provider's business location address is:

10400 75TH ST
KENOSHA, WI
ZIP 53142-884
Phone: (262) 697-7000

The NPI 1457335523 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician (HCPCS:62370)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Injection of lower or sacral spine facet joint using imaging guidance, second level (HCPCS:64494)
  • Injection of trigger points, 3 or more muscles (HCPCS:20553)
  • Fluoroscopic guidance for needle placement (HCPCS:77002)
  • Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes (HCPCS:99152)
  • Electronic analysis of implanted neurostimulator generator with complex spinal cord or peripheral nerve stimulator programming (HCPCS:95972)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level (HCPCS:64484)
  • Insertion of spinal neurostimulator electrode array through skin (HCPCS:63650)
  • Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance (HCPCS:27096)
  • Aspiration and/or injection of fluid from large joint (HCPCS:20610)
  • Destruction of nerve branches of knee using imaging guidance (HCPCS:64624)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, each additional facet joint (HCPCS:64636)
  • Injection of anesthetic agent and/or steroid into knee nerve branch using imaging guidance (HCPCS:64454)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Telephone medical discussion with physician, 11-20 minutes (HCPCS:99442)
  • Placement of stabilizing device to lower spine level (HCPCS:22869)
  • Spinal fusion (HCPCS:NAN02)

The enumeration date for this NPI number is 12/2/2005 and was last updated on 6/29/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiology39495-020WISCONSINNo
2207LP2900XAnesthesiologyPain Medicine39495WISCONSINNo
3208VP0014XPain MedicineInterventional Pain Medicine39495WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
132412100MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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