Individual provider Active NPI

Thomas E Reinardy, MD

  • Obstetrics & Gynecology Physician
  • De Pere, WI
National Provider Identifier
1194710509
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
35628 Issued in WI
Practice address
1716 Lawrence Dr Ste 100
De Pere, WI 54115-9108
Phone
(920) 605-3115
Fax
(920) 486-6826
NPI assigned
Sep 13, 2005
Last updated
Oct 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 35628 WI Primary

Addresses

Primary practice location

1716 Lawrence Dr Ste 100
De Pere, WI 54115-9108

Mailing address

1716 Lawrence Dr Ste 100
De Pere, WI 54115-9108
Phone (920) 605-3115

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080326000164 WI Practitioner - Obstetrics/Gynecology 6406852920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Wisconsin School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Gianna Molla Clinic, IncGroup PAC ID 2163836339, 5 clinicians

Practice addresses (Care Compare)

1716 Lawrence Dr
Suite 100
De Pere, WI 54115-9108
Phone (920) 605-3115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35628WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Gianna Molla Clinic, Inc Obstetrics & Gynecology CurrentSince Aug 15, 2023 Accepting new patients
Ear Nose & Throat Surgical Associates SC PastSince Aug 15, 2023 Accepting new patients

Locations

1716 Lawrence Dr
#100
De Pere, WI 54115
Phone (920) 605-3115

Interoperability endpoints

  • Direct secure messaging: thomas.reinardy.1@25400.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1194710509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 LAWRENCE DR STE 100",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108",
            "telephone_number": "920-605-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 LAWRENCE DR STE 100",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108",
            "telephone_number": "920-605-3115",
            "fax_number": "920-486-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINARDY",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "35628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.