Individual provider Active NPI

Joel J Tikalsky, DPM

  • Podiatrist
  • Weston, WI
National Provider Identifier
1073500526
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
895-025 Issued in WI
Practice address
2405 Schofield Ave Ste 110
Weston, WI 54476-6421
Phone
(715) 241-8100
Fax
(715) 241-8102
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 895-025 WI Primary

Addresses

Primary practice location

2405 Schofield Ave Ste 110
Weston, WI 54476-6421

Mailing address

2405 Schofield Ave Ste 110
Weston, WI 54476-6421
Phone (715) 241-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050323000782 WI Practitioner - Podiatry 5294781241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Foot and Ankle Clinic LLCGroup PAC ID 3072514876, 8 clinicians

Practice addresses (Care Compare)

100 S Court St
Merrill, WI 54452-2514
Phone (715) 241-8100

2400 Pine Ridge Blvd
Wausau, WI 54401-7803
Phone (715) 241-8100

5403 Normandy St
Weston, WI 54476-2217
Phone (715) 241-8100

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue49
Removal of nail tissue308
Removal or shaving of skin growth217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
895WIMDDiabetes Educator Registered Nurse
895-025WIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Foot and Ankle Clinic LLC Podiatrist CurrentSince Dec 1, 2006 Accepting new patients
Family Foot and Ankle Clinic LLC Podiatrist CurrentSince Dec 1, 2006 Accepting new patients
Advanced Foot & Ankle Center SC Podiatrist PastSince Nov 1, 2017 Accepting new patients
Family Foot and Ankle Center, SC Past Accepting new patients

Locations

737 Dorr St
Antigo, WI 54409
Phone (715) 623-4710

720 Ackley St
Antigo, WI 54409
Phone (715) 623-2292

100 S Court St
Merrill, WI 54452
Phone (715) 722-0999

140 Wilshire Blvd N
Stevens Point, WI 54481
Phone (715) 341-1266

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

2400 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2022

1901 Westwood Center Blvd
Wausau, WI 54401
Phone (715) 355-9424

2405 Schofield Ave
Ste 110
Weston, WI 54476
Phone (715) 298-5991

5403 Normandy St
Weston, WI 54476
Phone (262) 210-7820

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1073500526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 SCHOFIELD AVE STE 110",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544766421",
            "telephone_number": "715-241-8100",
            "fax_number": "715-241-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 SCHOFIELD AVE STE 110",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544766421",
            "telephone_number": "715-241-8100",
            "fax_number": "715-241-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIKALSKY",
        "first_name": "JOEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "895-025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, WI

Sources for this page

Verify at the official NPI Registry.