Individual provider Active NPI

Megan Smith Tolzien, PA-C

  • Physician Assistant
  • Madison, WI
National Provider Identifier
1790193464
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3395-23 Issued in WI
Practice address
3326 University Ave Apt 309
Madison, WI 53705-2161
Phone
(262) 617-7884
NPI assigned
Jul 25, 2014
Last updated
Feb 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3395-23 WI Primary

Addresses

Primary practice location

3326 University Ave Apt 309
Madison, WI 53705-2161

Mailing address

3326 University Ave Apt 309
Madison, WI 53705-2161

Other identifiers 1

IdentifierTypeStateIssuer
1790193464MedicaidWI

Other names 1

  • Megan E. Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3395WIMDProfessional Counselor
3395-23WIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1790193464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 UNIVERSITY AVE APT 309",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3326 UNIVERSITY AVE APT 309",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052161",
            "telephone_number": "262-617-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLZIEN",
        "first_name": "MEGAN",
        "middle_name": "SMITH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-25",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3395-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790193464",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "SMITH",
            "middle_name": "E.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.