NPIMap

Individual provider Active NPI

Todd S Fergus, MD

  • Cardiovascular Disease Physician
  • Green Bay, WI
National Provider Identifier
1083694111
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
47587-020 Issued in WI
Practice address
1727 Shawano Ave
Suite 201
Green Bay, WI 54303-3273
Phone
(920) 496-8877
Fax
(920) 496-3061
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 47587-020 WI Primary

Addresses

Primary practice location

1727 Shawano Ave
Suite 201
Green Bay, WI 54303-3273

Mailing address

1727 Shawano Ave
Suite 201
Green Bay, WI 54303-3273
Phone (920) 496-8877

Other identifiers 2

IdentifierTypeStateIssuer
P00606706OtherRAILROAD MEDICARE
34684700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050923000085 WI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9234163767 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Michigan Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, shared by 16 NPIs, 593 clinicians

Practice addresses (Care Compare)

1727 Shawano Ave
Green Bay, WI 54303-3268
Phone (920) 496-4700

3100 Superior Ave
Sheboygan, WI 53081-1948
Phone (920) 459-8300

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097
  • St Nicholas Hospital Hospital, Sheboygan, WI, CCN 520044
  • HSHS St Clare Memorial Hospital Hospital, Oconto Falls, WI, CCN 521310
  • Dickinson County Memorial Hospital Hospital, Iron Mountain, MI, CCN 230055

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47587-020WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prevea Clinic, Inc. CurrentSince May 19, 2008 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Cardiovascular Disease CurrentSince Aug 1, 2009 Accepting new patients
Prevea Clinic, Inc. Cardiovascular Disease CurrentSince May 19, 2008 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Sep 1, 2010 Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Oct 3, 2018 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Oct 3, 2018 Accepting new patients
St. Vincent Hospital-Hospital Sisters-Third Order of St. Francis CurrentSince Jul 19, 2017 Accepting new patients
St Mary'S Hospital Medical Center of Green Bay Inc.-Hospital Sisters CurrentSince Jul 19, 2017 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Current Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Cardiovascular Disease Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Aug 1, 2009 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Sep 1, 2010 Accepting new patients
St Clare Memorial Hospital, Inc. Past Accepting new patients
Prevea Regional Services, Inc. Past Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

1727 Shawano Ave
Green Bay, WI 54303
Phone (920) 431-1810

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1727 Shawano Ave
Ste 201
Green Bay, WI 54303
Phone (920) 496-8877

1860 Shawano Ave
Green Bay, WI 54303
Phone (920) 405-1414

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

835 S Main St
Oconto Falls, WI 54154
Phone (920) 846-0509

855 S Main St
Oconto Falls, WI 54154
Phone (920) 846-3444

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083694111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SHAWANO AVE",
            "address_2": "SUITE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033273",
            "telephone_number": "920-496-8877",
            "fax_number": "920-496-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SHAWANO AVE",
            "address_2": "SUITE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033273",
            "telephone_number": "920-496-8877",
            "fax_number": "920-496-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUS",
        "first_name": "TODD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "47587-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00606706",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34684700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.