Theresa M Cheng – Neurological Surgery Physician

Key facts

NPI: 1144214909
Entity type: Individual (NPI type 1)
Primary specialty: Neurological Surgery Physician 207T00000X
License: 36450 (WI)
Practice address: 2700 W 9TH Ave
Ste 203
Oshkosh, WI 54904-7247
Phone: (920) 236-1420
NPI assigned: Sep 8, 2005
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Ascension Medical Group-Fox Valley Wisconsin, Inc Cardiovascular Disease Physician · Appleton, WI · NPI 1831890177

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine, Doctor of Philosophy

State licenses

License	State	Type	Specialty
36450	WI	MD	Neurological Surgery Physician

Practice roles

Organization	Specialty	Status	New patients
Ascension Medical Group-Fox Valley Wisconsin, Inc		Past since Mar 19, 2023	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Neurological Surgery Physician	207T00000X	36450	WI	Yes

Addresses

Primary practice location

2700 W 9TH Ave
Ste 203
Oshkosh, WI 54904-7247

Mailing address

2700 W 9TH Ave
Ste 203
Oshkosh, WI 54904-7247
Phone (920) 236-1420

Other identifiers

Identifier	Type	State	Issuer
32119400	Medicaid	WI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 30, 2008.

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220054400000",
    "number": "1144214909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 W 9TH AVE",
            "address_2": "STE 203",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047247",
            "telephone_number": "920-236-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 W 9TH AVE",
            "address_2": "STE 203",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047247",
            "telephone_number": "920-236-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "THERESA",
        "middle_name": "M",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2008-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WI",
            "license": "36450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32119400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

All providers in Oshkosh, WI · Neurological Surgery Physician in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.