Individual provider Active NPI

Thomas M Bachhuber, M.D.

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1477558104
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29604 Issued in WI
Practice address
1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone
(414) 672-1353
Fax
(414) 672-4265
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29604 WI Primary

Addresses

Primary practice location

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203

Mailing address

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone (414) 672-1353

Other identifiers 4

IdentifierTypeStateIssuer
31554000MedicaidWI
4567717OtherWIAETNA
5608340OtherWIFIRST HEALTH CARE
0509990OtherWICIGNA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101020001558 WI Practitioner - Family Practice 6204029341 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29604WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
16TH Street Community Health Center Inc. Family Medicine Current Accepting new patients
Sixteenth Street Community Health Centers, Inc. Family Medicine CurrentSince Feb 28, 1993 Accepting new patients
Sixteenth Street Community Health Centers, Inc. Family Medicine CurrentSince Feb 28, 1993 Accepting new patients

Locations

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

Interoperability endpoints

  • Direct secure messaging: tbachhuber354292@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1477558104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353",
            "fax_number": "414-672-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353",
            "fax_number": "414-672-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHHUBER",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "29604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31554000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4567717",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH CARE",
            "identifier": "5608340",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0509990",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.