Individual provider Active NPI

Thomas H Pagel, PT

  • Physical Therapist
  • Fond Du Lac, WI
National Provider Identifier
1437289998
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5542 Issued in WI
Practice address
210 Wisconsin American Dr
Fond Du Lac, WI 54935-2999
Phone
(920) 907-7000
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5542 WI Primary

Addresses

Primary practice location

210 Wisconsin American Dr
Fond Du Lac, WI 54935-2999

Mailing address

368 Pinecrest CT
Mayville, WI 53050-2839
Phone (920) 296-0816

Other identifiers 1

IdentifierTypeStateIssuer
40356400MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address tpagel13711@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031204000210 WI Practitioner - Physical Therapist in Private Practice 2961307863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5542WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Sep 2, 2020 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Sep 2, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Center of Oshkosh, Inc Physical Therapist Past Accepting new patients

Locations

N112W17975 Mequon Rd
Germantown, WI 53022
Phone (262) 532-7600

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Interoperability endpoints

  • Direct secure messaging: tpagel13711@direct.myadvocateaurora.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1437289998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 PINECREST CT",
            "city": "MAYVILLE",
            "state": "WI",
            "postal_code": "530502839",
            "telephone_number": "920-296-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WISCONSIN AMERICAN DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352999",
            "telephone_number": "920-907-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGEL",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "5542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40356400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "210 Wisconsin American Dr",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549352999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpagel13711@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "210 Wisconsin American Dr",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549352999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.