Michael Charles Tankovich, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1415 Issued in WI

Practice address

3540-C North 126TH Street
Brookfield, WI 53005-2403

Phone

(262) 790-9559

Fax

(262) 790-9609

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659305191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 NEEDHAM ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611615",
            "telephone_number": "617-964-6681",
            "fax_number": "617-630-0141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540-C NORTH 126TH STREET",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052403",
            "telephone_number": "262-790-9559",
            "fax_number": "262-790-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANKOVICH",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "1415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T G Green DO SC
• Michael Anthony Tabor, MSPT
• Thomas A Taft, MD
• Sarah Tajnai
• Thomas T Tang, D.D.S.
• Daniel C Tanty, MD
• Brittney Nicole Tarmann
• Amanda Tatreau, APNP, FNP-BC
• Arriann Tauer, LPC
• Ashley Marlena Taylor, APNP

• Optometrist in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.