Active NPI
Thaddeus C Whiting, DO
- Family Medicine Physician
- Portage, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 49668
- Practice address
- 2825 Hunters TRL
Portage, WI 53901-3429 - Phone
- (608) 742-7161
- Fax
- (608) 745-3990
- NPI assigned
- Jun 1, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 49668 | WI | Primary |
Addresses
Primary practice location
2825 Hunters TRL
Portage, WI 53901-3429
Mailing address
2825 Hunters TRL
Portage, WI 53901-3429
Phone (608) 742-7161
Other practice location 1
2817 New Pinery Rd
Divine Savior Healthcare, Inc.
Portage, WI 53901-0387
Phone (608) 745-4598
Other practice location 2
Ascension-Plover Clinic
2401 Plover Road
Plover, WI 54467
Phone (715) 295-3800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497792113 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | twhiting408293@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
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
- R Franklin University of Med & Sci/Chicago Medical School, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2825 Hunters TRL
Portage, WI 53901-3429
Phone (608) 742-5522
Hospital & facility affiliations
- SSM Health at Home Home Health-Wisconsin
- SSM Health St Mary'S Hospital - Madison
- SSM Health St Clare Hospital - Baraboo
- Aspirus Divine Savior Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49668 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dean Health Systems, Inc | Family Medicine | Current | Accepting new patients |
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Dean Health Systems, Inc. | Current | Accepting new patients | |
| Divine Savior Healthcare, Inc. | Family Medicine | Current | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598
2825 Hunters Trl
Portage, WI 53901
Phone (608) 742-5522
Interoperability endpoints
- twhiting408293@direct-ehr-ssmhc.com
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.
-
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
Family Medicine
-
- Durable Medical Equipment & Medical Supplies
- Portage, WI
- NPI 1427085679
-
- Rural Health Clinic/Center
- Portage, WI
- NPI 1386154417
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
-
- Home Health Agency
- Madison, WI
- NPI 1275686404
-
- General Acute Care Hospital
- Baraboo, WI
- NPI 1386641207
-
- General Acute Care Hospital
- Madison, WI
- NPI 1184621211
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1497792113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2825 HUNTERS TRL",
"city": "PORTAGE",
"state": "WI",
"postal_code": "539013429",
"telephone_number": "608-742-7161",
"fax_number": "608-745-3990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 HUNTERS TRL",
"city": "PORTAGE",
"state": "WI",
"postal_code": "539013429",
"telephone_number": "608-742-7161",
"fax_number": "608-745-3990"
}
],
"practiceLocations": [
{
"address_1": "2817 New Pinery Rd",
"address_2": "Divine Savior Healthcare, Inc.",
"address_purpose": "LOCATION",
"city": "Portage",
"state": "WI",
"postal_code": "539010387",
"country_code": "US",
"telephone_number": "608-745-4598",
"fax_number": "608-745-6242",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "Ascension-Plover Clinic",
"address_2": "2401 Plover Road",
"address_purpose": "LOCATION",
"city": "Plover",
"state": "WI",
"postal_code": "54467",
"country_code": "US",
"telephone_number": "715-295-3800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITING",
"first_name": "THADDEUS",
"middle_name": "C",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "49668",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497792113",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "twhiting408293@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "twhiting408293@direct-ehr-ssmhc.com",
"address_1": "2825 Hunters Trl",
"city": "Portage",
"state": "WI",
"country_code": "US",
"postal_code": "539013429",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "2825 Hunters Trl",
"city": "Portage",
"state": "WI",
"country_code": "US",
"postal_code": "539013429",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Portage, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.