Timothy A Moureau, APNP CDE

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

446 Issued in WI

Practice address

525 Airport Dr
Oneida, WI 54155-9035

Phone

(920) 869-2711

NPI assigned

Oct 11, 2005

Last updated

Nov 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

93.87 of 100Reported as group

Quality

76.81

Promoting interoperability

100

Improvement activities

40

Cost

86.09

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Oneida Nation

  • Clinic/Center
  • Oneida, WI
  • NPI 1740278308
  Medicare reassignment NPD

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1710975065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "ONEIDA",
            "state": "WI",
            "postal_code": "541550365",
            "telephone_number": "920-869-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 AIRPORT DR",
            "city": "ONEIDA",
            "state": "WI",
            "postal_code": "541559035",
            "telephone_number": "920-869-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUREAU",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "APNP CDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "446",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "91719",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500001880",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43838600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather J Lallaman, RDH
• Mary C Lamers, RPH
• Kalyn Elizabeth Leege, PTA
• Heidi McCann, RD
• Kaitlyn Moser, RD, CD
• Bridget A Nelson, RDH
• Brett R Olm, DDS MS
• Oneida Nation
• Oneida Nation (Anna John Resident Centered Care Community)
• Oneida Nation (Oneida Community Health Center LTC Pharmacy)

• Nurse Practitioner in Oneida, WI
• Providers in Oneida, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.