TIMOTHY J SANNER – Physician Assistant, NPI 1093309569

TIMOTHY J SANNER is a healthcare provider. based in Appleton, Wisconsin. specializing in PHYSICIAN ASSISTANT. They hold a License No. 5468-23 (WI). The NPI Number for TIMOTHY J SANNER is 1093309569

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY J SANNER
NPI
1093309569
Phone
Not provided
Address
701 S NICOLET RD
Enumeration Date
25 February 2021
Last Update Date
6 July 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9202233000
Graduation Year
2021 (5 years ago)
PAC ID
2668875527
Group Practice PAC ID
0244142420
Professional Enrollment ID
I20210729001868
Address ID
WI549047944OS500XXRDXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,703 PHYSICIAN ASSISTANT in WI

Provider Addresses for TIMOTHY J SANNER

  • 701 S NICOLET RD

    APPLETON, WI 549148273

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $228.

Total Amount is formed as General ($228) + Research ($0) + Ownership ($0) = $228.

Last reported payment date: 2023-08-08 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($228).

Total Amount

$228

General + Research + Ownership

Payments

3

Total payment records

General Amount

$228

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-08

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Intuitive Surgical, Inc.$228
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-07-29

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210729001868IPhysician AssistantWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 54914)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244142420View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to TIMOTHY J SANNER?
NPI 1093309569 is assigned to TIMOTHY J SANNER under the national enumeration system.
Does this profile mean TIMOTHY J SANNER is currently active?
Yes — TIMOTHY J SANNER appears active in the national provider directory.
Does TIMOTHY J SANNER list a primary specialty?
If you are matching referrals, note Physician Assistant for TIMOTHY J SANNER. Clinical services aligned with this taxonomy classification.
Where does public data place TIMOTHY J SANNER?
The snapshot lists Appleton, Wisconsin for TIMOTHY J SANNER; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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