Individual provider Active NPI

Megan A Tkachuk, MD

  • Family Medicine Physician
  • Hartford, WI
National Provider Identifier
1790719086
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47320 Issued in WI
Practice address
1640 E Sumner St
Hartford, WI 53027
Phone
(262) 670-4000
Fax
(262) 670-4001
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47320 WI Primary

Addresses

Primary practice location

1640 E Sumner St
Hartford, WI 53027

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other identifiers 2

IdentifierTypeStateIssuer
34602800MedicaidWI
P01087256OtherWYRR MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mtkachuk13349@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20050110000401 WI Practitioner - Family Practice 2668420332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1061 E Commerce Boulevard
Slinger, WI 53086-9326
Phone (262) 644-2900

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47320WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Sep 1, 2006 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 1, 2006 Accepting new patients
Aurora Advanced Healthcare, Inc. Family Medicine CurrentSince Mar 14, 2011 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Mar 14, 2011 Accepting new patients
Prohealth Medical Group Inc Family Medicine Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

1004 E Sumner St
Hartford, WI 53027
Phone (262) 670-7000

1640 E Sumner St
Hartford, WI 53027
Phone (262) 670-4000

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

Interoperability endpoints

  • Direct secure messaging: mtkachuk13349@direct.myadvocateaurora.org

Organizations & group practices 5

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 6

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1790719086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 E SUMNER ST",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "53027",
            "telephone_number": "262-670-4000",
            "fax_number": "262-670-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACHUK",
        "first_name": "MEGAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "47320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34602800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01087256",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtkachuk13349@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1640 E Sumner St",
            "city": "Hartford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1640 E Sumner St",
            "city": "Hartford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, WI

Sources for this page

Verify at the official NPI Registry.