Timothy E Hazard, FNP
Individual provider Active NPI Nurse Practitioner · Denmark, WI
NPI 1003199720 · NPPES record last updated Jul 25, 2025
Key facts
- NPI
- 1003199720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 6952 (WI)
- Practice address
- 629 Solvang Way
Denmark, WI 54208 - Phone
- (920) 863-2600
- NPI assigned
- Sep 20, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aurora Medical Group, Inc.
Practice addresses (Care Compare)
629 Solvang Way
Denmark, WI 54208-8951
Phone (920) 863-2600
Hospital & facility affiliations
- Aurora Baycare Medical Ctr
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160713002031 | WI | Practitioner - Nurse Practitioner | 2062670052 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6952 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1881 Chicago St
De Pere, WI 54115
Phone (920) 403-8000
629 Solvang Way
Denmark, WI 54208
Phone (920) 863-2600
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
1910 Alabama St
Sturgeon Bay, WI 54235
Phone (920) 746-7200
Interoperability endpoints
- thazard178472@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 6952 | WI | Yes |
Addresses
Primary practice location
629 Solvang Way
Denmark, WI 54208
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-6250
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003199720 | Medicaid | WI | |
| 363F0000X | Other | IL | TAXONOMY# |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | thazard178472@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Other providers in Denmark, WI
- Bellin Memorial Hospital Inc
- Mark John Dehnel
- Denmark Family Dentistry, S.C.
- Denmark Senior Living, Inc.
- Cari L Duffy-Sebero
- Jane Marie Hertel
- Deborah Ann Hoffman
- Hospital Dentistry for Kids Inc.
- Dana Marie Hunter
- Jennifer Anne Johnson
All providers in Denmark, WI · Nurse Practitioner in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2025. 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.