NPIMap

Individual provider Active NPI

Sara Helena Tikkanen Swift, M.D

  • Obstetrics & Gynecology Physician
  • Neenah, WI
National Provider Identifier
1407082381
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
60736-20 Issued in WI
Practice address
200 Theda Clark Medical PLZ Ste 130
Neenah, WI 54956-2790
Phone
(920) 729-7105
NPI assigned
Jun 5, 2009
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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 60736-20 WI Primary

Addresses

Primary practice location

200 Theda Clark Medical PLZ Ste 130
Neenah, WI 54956-2790

Mailing address

3232 N Ballard Rd Ste 100
Appleton, WI 54911-8804
Phone (920) 729-7105

Other identifiers 1

IdentifierTypeStateIssuer
100031441MedicaidWI

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
I20131010000180 WI Practitioner - Obstetrics/Gynecology 4183858962 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Wisconsin School of Medicine, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Theda Clark OB Hospitalists SCGroup PAC ID 9335592187, 2 clinicians
Womens Care of Wisconsin SCGroup PAC ID 3072416601, 23 clinicians

Practice addresses (Care Compare)

130 2ND St
Neenah, WI 54956-2883
Phone (920) 729-7105

200 Theda Clark Medical PLZ
Suite 130
Neenah, WI 54956-2790
Phone (920) 729-7105

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60736-20WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care of Wisconsin S.C. Obstetrics & Gynecology CurrentSince Mar 31, 2020 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Nov 16, 2017 Accepting new patients
Theda Clark OB Hospitalists SC Obstetrics & Gynecology CurrentSince Feb 5, 2024 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Nov 16, 2017 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3232 N Ballard Rd
Ste 100
Appleton, WI 54911

801 Main Ave
De Pere, WI 54115
Phone (920) 330-9033

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

200 Theda Clark Medical Plz
Ste 130
Neenah, WI 54956

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

100 County Road B
Ste 4
Shawano, WI 54166

E3277 Apple Tree Ln
Waupaca, WI 54981
Phone (715) 256-0358

Interoperability endpoints

  • Direct secure messaging: sswift285972@direct.thedacare.org

Organizations & group practices 4

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1407082381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD STE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-729-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ STE 130",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562790",
            "telephone_number": "920-729-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWIFT",
        "first_name": "SARA",
        "middle_name": "HELENA TIKKANEN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "60736-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100031441",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.