Christopher Thomas Deroche, DPM
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Plover, WI
NPI 1790763779 · NPPES record last updated Aug 6, 2025
Key facts
- NPI
- 1790763779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 703-025 (WI)
- Practice address
- 2020 Country Rd HH
Plover, WI 54467 - Phone
- (715) 344-9500
- Fax
- (715) 344-9501
- NPI assigned
- Jan 9, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- William M. Scholl College of Podiatric Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2020 County Rd HH
Plover, WI 54467-2653
Phone (715) 344-9500
Hospital & facility affiliations
- Thedacare Medical Center-Waupaca
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 478 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071029000388 | WI | Practitioner - Podiatry | 3476551573 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 703-025 | WI | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C. Thomas Deroche, DPM, LLC | Podiatrist | Current |
Accepting new patients |
| Plaza Podiatry Associates LLC | Foot & Ankle Surgery | Past | Accepting new patients |
| Sleep Apnea Care and Wellness, LLC | Past |
Accepting new patients |
Locations
N2665 County Road QQ
#H
King, WI 54946
Phone (715) 258-1492
N2665 County Road QQ
King, WI 54946
Phone (715) 258-1674
2020 County Road HH
Plover, WI 54467
Phone (715) 341-5001
508 Vincent St
Stevens Point, WI 54481
Phone (715) 344-9500
800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000
425 Summit St
Wild Rose, WI 54984
Phone (920) 622-3750
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 703-025 | WI | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 703-025 | WI | Yes |
Addresses
Primary practice location
2020 Country Rd HH
Plover, WI 54467
Mailing address
2020 Country Rd HH
Plover, WI 54467
Phone (715) 344-9500
Other practice location 1
508 Vincent St
Stevens Point, WI 54481-1848
Phone (715) 344-9500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43220000 | Medicaid | WI | |
| P00437506 | Other | WI | PALMETTO MEDICARE |
Other providers in Plover, WI
- Cornerstone Clinic LLC
- Genesis Anne Cratsenberg
- Clare A Cullen
- Joshua Alan Deisinger
- Daniel G. Derezinski
- Sara R Ebel
- Mark S Ensweiler
- Mark F Fenlon
- Heidi Renee Filko
- Kimm Fonti
All providers in Plover, WI · Foot & Ankle Surgery Podiatrist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.