Ted M Pagoaga, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6524 Issued in WI

Practice address

W18105 Hemlock Rd
Wittenberg, WI 54499-8647

Phone

(715) 253-2116

Fax

(715) 253-3586

NPI assigned

Dec 13, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Ihc Health Services Inc

  dba IMED Physicians Billing

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba Primary Children's Hospital Child Psychology & Psychiatry

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taylorsville, UT
  • NPI 1063536381
  NPD
• Lutheran Social Services of Wisconsin and Upper Michigan, Inc.

  dba LSS Homme

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Wittenberg, WI
  • NPI 1326113887
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780745430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E MCKINLEY ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891624",
            "telephone_number": "605-873-3103",
            "fax_number": "608-873-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W18105 HEMLOCK RD",
            "city": "WITTENBERG",
            "state": "WI",
            "postal_code": "544998647",
            "telephone_number": "715-253-2116",
            "fax_number": "715-253-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGOAGA",
        "first_name": "TED",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4092550",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MCHS Hospitals Inc (Marshfield Clinic Wittenberg Center)
• Roslyn Dee McKay, WHNP
• Molly Meverden
• Mark Shannon Milne, PT
• Joan D Ostermeier, PT
• Quirt Family Dentistry, SC (Quirt Family Dentistry - Wittenberg)
• Jamie Lynn Rasmussen, RD
• Raymond M Goga
• Shane Resch
• Alice Schmutzler, NP

• Clinical Social Worker in Wittenberg, WI
• Providers in Wittenberg, WI by specialty
• Clinical Social Worker 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.