NPIMap

Individual provider Active NPI

Thomas C Wald, MD

  • Internal Medicine Physician
  • Wausau, WI
National Provider Identifier
1164438040
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36533 Issued in WI
Practice address
425 Pine Ridge Blvd
Suite 200
Wausau, WI 54401-4123
Phone
(715) 847-2480
NPI assigned
Jul 31, 2006
Last updated
Sep 18, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36533 WI Primary

Addresses

Primary practice location

425 Pine Ridge Blvd
Suite 200
Wausau, WI 54401-4123

Mailing address

PO Box 1008
Wausau, WI 54402-1008
Phone (715) 847-2304

Other identifiers 1

IdentifierTypeStateIssuer
32111500MedicaidWI

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
I20100326000660 WI Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6507992708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
University of Minnesota Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Pulmonary Medicine SCGroup PAC ID 6002707320, 12 clinicians

Practice addresses (Care Compare)

2500 E Capitol Dr
Suite 2600
Appleton, WI 54911-8735
Phone (920) 358-1139

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Jul 1, 2003 Accepting new patients
Fox Valley Pulmonary Medicine, S.C. CurrentSince Jan 1, 2021 Accepting new patients
Aspirus Wausau Hospital, Inc. Internal Medicine Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2500 E Capitol Dr
Ste 2600
Appleton, WI 54911
Phone (920) 358-1139

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

200 Theda Clark Medical Plz
Ste 480
Neenah, WI 54956
Phone (920) 729-0608

2720 Plaza Dr
Ste 1400A
Wausau, WI 54401
Phone (715) 847-0426

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

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

425 Pine Ridge Blvd
Ste 200
Wausau, WI 54401
Phone (715) 847-0075

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253232000000",
    "number": "1164438040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1008",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544021008",
            "telephone_number": "715-847-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-847-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALD",
        "first_name": "THOMAS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "36533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32111500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.