NPIMap

Organization Active NPI

Tower Clock Surgery Center Appleton, LLC

Doing business as Tower Clock Surgery Center Appleton

  • Ambulatory Surgical Clinic/Center
  • Appleton, WI
National Provider Identifier
1568244192
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
TOWER CLOCK SURGERY CENTER APPLETON, LLC
Doing business as
Tower Clock Surgery Center Appleton
Practice address
3120 N Richmond St
Appleton, WI 54911-1151
Phone
(920) 497-1810
Fax
(920) 497-1830
NPI assigned
Oct 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Dr. Matthew J Thompson, MDNPI 1659336733
Title
Owner/Ophthalmologist
Phone
(920) 497-1810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3120 N Richmond St
Appleton, WI 54911-1151

Mailing address

3120 N Richmond St
Appleton, WI 54911-1151
Phone (920) 497-1810

Other names 1

  • Tower Clock Surgery Center Appleton Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240612001934 WI Part B Supplier - Ambulatory Surgical Center 2567904055 Practice locations: Appleton, WI

Ambulatory surgical center certification: CCN 52C0001153

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Tower Clock Surgery Center Appleton, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jul 29, 2024
Last certification
Jul 29, 2024
Ownership / control type
Proprietary
Facility address
3120 N. Richmond St.
Appleton, WI 54911

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2301573Tower Clock Surgery Center Appleton3120 N Richmond Street, Appleton, WI 54911Certificate of waiverMar 27, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1568244192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 N RICHMOND ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111151",
            "telephone_number": "920-497-1810",
            "fax_number": "920-497-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 N RICHMOND ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111151",
            "telephone_number": "920-497-1810",
            "fax_number": "920-497-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWER CLOCK SURGERY CENTER APPLETON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "920-497-1810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tower Clock Surgery Center Appleton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.