Active NPI
Timothy J Hamel, MD
- Family Medicine Physician
- Monroe, WI
National Provider Identifier
1417021882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036-065108
- Practice address
- 515 22ND Ave
Monroe, WI 53566-1569 - Phone
- (608) 324-1000
- NPI assigned
- Nov 20, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 25281 | WI | |
| Family Medicine Physician | 207Q00000X | 036-065108 | IL | Primary |
Addresses
Primary practice location
515 22ND Ave
Monroe, WI 53566-1569
Mailing address
515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-1000
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30530500 | Medicaid | WI | |
| 690004890 | Other | MEDICARE RAILROAD | |
| 390808509 | Other | CIGNA | |
| 39080850932 | Other | UNITY | |
| 80054809 | Other | MEDICARE RAILROAD | |
| 1007476 | Other | PHYSICIANS PLUS | |
| 10866 | Other | DEAN HEALTH PLAN | |
| 390808509 | Other | CT GENERAL | |
| 390808509 | Other | WPS | |
| 30530500 | Other | HIRSP | |
| 90002361 | Other | WEA INS |
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 |
|---|---|---|---|
| 25281 | WI | MD | Emergency Medicine Physician |
| 036-065108 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Monroe Clinic, Inc. | Current | Accepting new patients |
Locations
400 S Center St
Durand, IL 61024
Phone (815) 248-3443
1301 Kiwanis Dr
Freeport, IL 61032
Phone (815) 235-1406
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
Interoperability endpoints
- thamel407940@direct-ehr-ssmhc.com
Organizations & group practices 1
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.
-
dba SSM Health Monroe Clinic Medical Group
- Specialist
- Monroe, WI
- NPI 1386720548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1417021882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "515 22ND AVE",
"city": "MONROE",
"state": "WI",
"postal_code": "535661569",
"telephone_number": "608-324-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 22ND AVE",
"city": "MONROE",
"state": "WI",
"postal_code": "535661569",
"telephone_number": "608-324-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMEL",
"first_name": "TIMOTHY",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "25281",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-065108",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30530500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "690004890",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "390808509",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITY",
"identifier": "39080850932",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "80054809",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIANS PLUS",
"identifier": "1007476",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEAN HEALTH PLAN",
"identifier": "10866",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CT GENERAL",
"identifier": "390808509",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WPS",
"identifier": "390808509",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIRSP",
"identifier": "30530500",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WEA INS",
"identifier": "90002361",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Monroe, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.