Cynthia A Pangallo, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

32603 Issued in WI

Practice address

888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342

Phone

(262) 567-1499

Fax

(262) 567-4502

NPI assigned

Mar 23, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Wisconsin School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Oconomowoc Memorial Hospital Hospital, Oconomowoc, WI, CCN 520062
• Aspirus Divine Savior Hospital Hospital, Portage, WI, CCN 520041

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpangallo14744@direct.phci.org
• Direct secure messaging: cpangallo177810@direct.aspirus.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/

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.

• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Medicare reassignment Care Compare group NPD
• Prohealth Medical Group Inc.

  • Pediatrics Physician
  • Waukesha, WI
  • NPI 1356322440

  Surgery

  Medicare reassignment Care Compare group NPD
• Aspirus Riverview Hospital & Clinics, Inc.

  dba Aspirus Outpatient Therapies - Wisconsin Rapids

  • General Acute Care Hospital
  • Wisconsin Rapids, WI
  • NPI 1295754844
  Medicare reassignment NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1538112230
  Medicare reassignment NPD
• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361

  Surgery

  Medicare reassignment NPD
• Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin

  • Critical Access Hospital
  • Antigo, WI
  • NPI 1639187412
  Medicare reassignment NPD
• The Howard Young Medical Center, Inc.

  dba Howard Young Medical Center

  • General Acute Care Hospital
  • Woodruff, WI
  • NPI 1184673352
  Medicare reassignment NPD
• Aspirus Medford Hospital & Clinics, Inc.

  dba Aspirus Gilman Clinic

  • Rural Health Clinic/Center
  • Gilman, WI
  • NPI 1285703173
  Medicare reassignment
• Aspirus Medford Hospital & Clinics, Inc.

  dba Aspirus Medford Hospital

  • Critical Access Hospital
  • Medford, WI
  • NPI 1619079597
  Medicare reassignment
• Aspirus Medical Group, Inc.

  dba Aspirus Womens Health

  • Clinic/Center
  • Wausau, WI
  • NPI 1003021452
  Medicare reassignment
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  dba Aspirus Stevens Point Clinic - Illinois Avenue

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment
• Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin

  dba Aspirus Elcho Clinic

  • Rural Health Clinic/Center
  • Elcho, WI
  • NPI 1831251040
  Medicare reassignment

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

• Divine Savior Healthcare, Inc.

  dba Aspirus Divine Savior Hospital

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Oconomowoc, WI
  • NPI 1366420531
  Care Compare affiliation
• Prohealth Oconomowoc Memorial Hospital, Inc.

  dba ProHealth Pharmacy - Oconomowoc

  • Community/Retail Pharmacy
  • Oconomowoc, WI
  • NPI 1497942205

  Hospital

  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1710946132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 103",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-567-1499",
            "fax_number": "262-567-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 103",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-567-1499",
            "fax_number": "262-567-4502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1185 Corporate Center Dr",
            "address_2": "ste 200",
            "address_purpose": "LOCATION",
            "city": "Oconomowoc",
            "state": "WI",
            "postal_code": "530664845",
            "country_code": "US",
            "telephone_number": "262-567-1499",
            "fax_number": "262-567-4502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANGALLO",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "32603",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "32603",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "WI",
            "license": "32603",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317237300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Marie Osterday, RPH
• Miranda Overland
• P. a. Janusonis, M.D., S.C.
• James T Paloucek, M.D.
• Katherine L Pampuch, NP
• Stephen Ernest Paquin, RPH
• Paragon Industries Inc (Paragon Work Services)
• Kelly D Parish
• Parkins Plastic Surgery
• Jennifer Parra Nelsen, LPC

• Surgery Physician in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.