Theresa Marie Pardoe, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

29660 Issued in WI

Practice address

9305 W National Ave
West Allis, WI 53227-1541

Phone

(414) 545-1120

Fax

(414) 545-2505

NPI assigned

May 20, 2006

Last updated

Oct 1, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

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.

• Theresa Pardoe D.O.

  • Family Medicine Physician
  • West Allis, WI
  • NPI 1083635189
  NPD (past) Authorized official

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1215981733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 W NATIONAL AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271541",
            "telephone_number": "414-545-1120",
            "fax_number": "414-545-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 W NATIONAL AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532271541",
            "telephone_number": "414-545-1120",
            "fax_number": "414-545-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDOE",
        "first_name": "THERESA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "29660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31462700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Marie Palmisano, OT
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• Jacob Papke, PA-C
• Alexander Helander Paque
• Andrew William Paquette, PT
• Keyur H Parikh, M.D.
• Park Dentistry LLC (Gentle Smiles Dentistry)
• Sarah E Parker, MA, BCBA
• Shelly Schneider Parker, CRNA
• Chris Leon Parrish, LPC-IT

• Family Medicine Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.