Individual provider Active NPI

Thomas Raimann, DDS

  • Dentist
  • Hales Corners, WI
National Provider Identifier
1700293768
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2476 Issued in WI
Practice address
11801 W Janesville Rd
Hales Corners, WI 53130-2327
Phone
(414) 425-1510
NPI assigned
Jul 22, 2014
Last updated
Jul 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2476 WI Primary

Addresses

Primary practice location

11801 W Janesville Rd
Hales Corners, WI 53130-2327

Mailing address

11801 W Janesville Rd
Hales Corners, WI 53130-2327
Phone (414) 425-1510

Other identifiers 1

IdentifierTypeStateIssuer
33408800MedicaidWI

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160831000157 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1153617170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas E. Raimann DDS Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1700293768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 W JANESVILLE RD",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302327",
            "telephone_number": "414-425-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 W JANESVILLE RD",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531302327",
            "telephone_number": "414-425-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIMANN",
        "first_name": "THOMAS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "2476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33408800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

Verify at the official NPI Registry.