Active NPI
Cuong Tieu, M.D.
- Child & Adolescent Psychiatry Physician
- Oconomowoc, WI
National Provider Identifier
1245304716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 48587-020
- Practice address
- 34700 Valley Rd
Oconomowoc, WI 53066-4500 - Phone
- (262) 646-1391
- Fax
- (262) 646-1393
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 48587-020 | WI | Primary |
| Psychiatry Physician | 2084P0800X | 48587-020 | WI | |
| General Practice Physician | 208D00000X | 48587-020 | WI | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | N1475 | TX | |
| Psychiatry Physician | 2084P0800X | N1475 | TX |
Addresses
Primary practice location
34700 Valley Rd
Oconomowoc, WI 53066-4500
Mailing address
34700 Valley Rd
Oconomowoc, WI 53066-4500
Phone (262) 646-1391
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 217454201 | Medicaid | TX | |
| 8CH496 | Other | TX | BCBS |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48587-020 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rogers Memorial Hospital Incorporated | Current | Accepting new patients | |
| Tri-County Clinical | Past | Accepting new patients | |
| County of Milwaukee | Psychiatry | Past | Accepting new patients |
Locations
34700 Valley Rd
Oconomowoc, WI 53066
1230 Corporate Center Dr
Ste 400
Oconomowoc, WI 53066
Phone (262) 560-1527
1205 Corporate Center Dr
Oconomowoc, WI 53066
Phone (262) 567-4828
11101 W Lincoln Ave
West Allis, WI 53227
Phone (414) 203-4500
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 and National Provider Directory roles.
-
- Psychiatric Hospital
- Oconomowoc, WI
- NPI 1053329581
-
- Psychiatry Physician
- Milwaukee, WI
- NPI 1831256353
-
- Family Medicine Physician
- Luling, TX
- NPI 1336456227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407888000000",
"number": "1245304716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34700 VALLEY RD",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530664500",
"telephone_number": "262-646-1391",
"fax_number": "262-646-1393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34700 VALLEY RD",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530664500",
"telephone_number": "262-646-1391",
"fax_number": "262-646-1393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIEU",
"first_name": "CUONG",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2014-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "WI",
"license": "48587-020",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "48587-020",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WI",
"license": "48587-020",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "TX",
"license": "N1475",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "N1475",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "217454201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8CH496",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oconomowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.