Individual provider Active NPI

Todd Andrew Neideen, M.D.

  • Surgical Critical Care Physician
  • Milwaukee, WI
National Provider Identifier
1720172893
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
47078-20 Issued in WI
Practice address
9200 W Wisconsin Ave
Trauma and Critical Care Surgery
Milwaukee, WI 53226-3522
Phone
(414) 805-8623
Fax
(414) 805-8641
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 47078-20 WI
Surgical Critical Care Physician 2086S0102X 47078-20 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Trauma and Critical Care Surgery
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Trauma and Critical Care Surgery
Milwaukee, WI 53226-3522
Phone (414) 805-8623

Other identifiers 1

IdentifierTypeStateIssuer
1720172893MedicaidWI

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090611000327 WI Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 0345390449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47078-20WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. Surgery CurrentSince Jun 2, 2009 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 15, 2013 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients
The Medical College of Wisconsin Inc Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: tneideenmd32422@direct.froedtert.com

Organizations & group practices 4

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1720172893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "TRAUMA AND CRITICAL CARE SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8623",
            "fax_number": "414-805-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "TRAUMA AND CRITICAL CARE SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8623",
            "fax_number": "414-805-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEIDEEN",
        "first_name": "TODD",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "47078-20",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WI",
            "license": "47078-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720172893",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.