Individual provider Active NPI

Ngii N Tazeh, M.D., PH.D

  • Urology Physician
  • Monroe, WI
National Provider Identifier
1508123787
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
61264 Issued in WI
Practice address
515 22ND Ave
Monroe, WI 53566-1569
Phone
(608) 324-2222
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 61264 WI Primary

Addresses

Primary practice location

515 22ND Ave
Monroe, WI 53566-1569

Mailing address

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 628-3965

Other names 1

  • Ngii Nkhanglefack Tazeh Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ntazeh9632@direct.monroeclinic.org Direct
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170728002881 WI Practitioner - Urology 5890927255 Reassigns benefits to 1 organization
I20170926003092 IL Practitioner - Urology 5890927255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Iowa, RJ & L Carver College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Monroe Clinic, Inc.Group PAC ID 3072425495, shared by 7 NPIs, 199 clinicians

Practice addresses (Care Compare)

1301 Kiwanis Dr
Freeport, IL 61032-6907
Phone (815) 235-1406

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

Hospital & facility affiliations

  • The Monroe Clinic Hospital, Monroe, WI, CCN 520028

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61264WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Monroe Clinic, Inc. CurrentSince Aug 21, 2017 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Aug 21, 2017 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Aug 21, 2017 Accepting new patients

Locations

1301 Kiwanis Dr
Freeport, IL 61032
Phone (815) 235-1406

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

2009 5th St
Monroe, WI 53566
Phone (608) 324-1454

225 Church St
Stoughton, WI 53589
Phone (608) 877-2700

Interoperability endpoints

  • Direct secure messaging: ntazeh386557@direct-ehr-ssmhc.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1508123787",
    "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": "608-628-3965"
        },
        {
            "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": "608-324-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAZEH",
        "first_name": "NGII",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "61264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntazeh9632@direct.monroeclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ntazeh9632@direct.monroeclinic.org",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NGII",
            "last_name": "TAZEH",
            "middle_name": "NKHANGLEFACK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monroe, WI

Sources for this page

Verify at the official NPI Registry.