Individual provider Active NPI

Timothy Kevin Tougas, DPM

  • Primary Podiatric Medicine Podiatrist
  • Appleton, WI
National Provider Identifier
1093711491
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
604-025 Issued in WI
Practice address
1301 E Northland Ave
Suite B
Appleton, WI 54911-8582
Phone
(920) 731-1999
Fax
(920) 731-3729
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 604-025 WI Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 604-025 WI

Addresses

Primary practice location

1301 E Northland Ave
Suite B
Appleton, WI 54911-8582

Mailing address

1301 E Northland Ave Ste B
Appleton, WI 54911-8582
Phone (920) 731-1999

Other identifiers 2

IdentifierTypeStateIssuer
391776284013OtherWIBLUE CROSS BLUE SHIELD
43222200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930090274 WI DME Supplier - Physician - Podiatry 8527000850 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Appleton, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
604-025WIMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1093711491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E NORTHLAND AVE STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118582",
            "telephone_number": "920-731-1999",
            "fax_number": "920-731-3729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E NORTHLAND AVE",
            "address_2": "SUITE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118582",
            "telephone_number": "920-731-1999",
            "fax_number": "920-731-3729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOUGAS",
        "first_name": "TIMOTHY",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "WI",
            "license": "604-025",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "604-025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "391776284013",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43222200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.