Organization Active NPI

Hoffman Geriatric Services SC

  • Geriatric Medicine (Family Medicine) Physician
  • Manitowoc, WI
National Provider Identifier
1396835328
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
37871020 Issued in WI
Legal business name
HOFFMAN GERIATRIC SERVICES SC
Practice address
2021 S Alverno Rd
Manitowoc, WI 54220
Phone
(920) 686-1822
Fax
(920) 686-7448
NPI assigned
Oct 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Tracy L Hoffman
Title
Owner
Phone
(920) 686-1822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 37871020 WI Primary

Addresses

Primary practice location

2021 S Alverno Rd
Manitowoc, WI 54220

Mailing address

2021 S Alverno Rd
Manitowoc, WI 54220
Phone (920) 686-1822

Other identifiers 1

IdentifierTypeStateIssuer
32241400MedicaidWI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396835328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 S ALVERNO RD",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-686-1822",
            "fax_number": "920-686-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 S ALVERNO RD",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "54220",
            "telephone_number": "920-686-1822",
            "fax_number": "920-686-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOFFMAN GERIATRIC SERVICES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-686-1822",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "37871020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32241400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.