Active NPI
Todd R Nelson, M.D.
- Family Medicine Physician
- Burlington, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 56176
- Practice address
- 248 McHenry St
Burlington, WI 53105-1828 - Phone
- (262) 767-8000
- NPI assigned
- May 24, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 56176 | WI | Primary |
Addresses
Primary practice location
248 McHenry St
Burlington, WI 53105-1828
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
240 Maple Ave
ProHealth Care Medical Associates Inc.
Mukwonago, WI 53149-8475
Phone (262) 928-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100031467 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | tnelson156396@direct.myadvocateaurora.org |
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
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
248 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-8000
Hospital & facility affiliations
- Aurora at Home
- Aurora Memorial Hospital Burlington
- Aurora Lakeland Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56176 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Prohealth Medical Group Inc | Family Medicine | Past | Accepting new patients |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
248 McHenry St
Burlington, WI 53105
Phone (262) 767-8000
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Family Medicine
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
-
- Family Medicine Physician
- Waukesha, WI
- NPI 1790720613
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Burlington, WI
- NPI 1861557753
-
- General Acute Care Hospital
- Elkhorn, WI
- NPI 1972628006
-
- Home Health Agency
- West Allis, WI
- NPI 1134255037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1457562126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 MCHENRY ST",
"city": "BURLINGTON",
"state": "WI",
"postal_code": "531051828",
"telephone_number": "262-767-8000"
}
],
"practiceLocations": [
{
"address_1": "240 Maple Ave",
"address_2": "ProHealth Care Medical Associates Inc.",
"address_purpose": "LOCATION",
"city": "Mukwonago",
"state": "WI",
"postal_code": "531498475",
"country_code": "US",
"telephone_number": "262-928-1900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON",
"first_name": "TODD",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "56176",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100031467",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "240 Maple Ave",
"address_2": "ProHealth Care Medical Associates Inc.",
"city": "Mukwonago",
"state": "WI",
"country_code": "US",
"postal_code": "531498475",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tnelson156396@direct.myadvocateaurora.org",
"affiliation": "N",
"address_1": "240 Maple Ave",
"address_2": "ProHealth Care Medical Associates Inc.",
"city": "Mukwonago",
"state": "WI",
"country_code": "US",
"postal_code": "531498475",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Burlington, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.