NPIMap

Individual provider Active NPI

Hannah R Tumilty, MD

  • Family Medicine Physician
  • Grand Chute, WI
National Provider Identifier
1831652775
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75245-20 Issued in WI
Practice address
3750 Investors CT
Grand Chute, WI 54913-2330
Phone
(920) 496-4700
NPI assigned
Apr 8, 2019
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 75245-20 WI Primary

Addresses

Primary practice location

3750 Investors CT
Grand Chute, WI 54913-2330

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address htumilty309534@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221020001747 WI Practitioner - Family Practice 6800299819 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Oct 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Oct 1, 2022 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Family Medicine Current Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Oct 1, 2022 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Oct 1, 2022 Accepting new patients
Prevea Clinic, Inc. Family Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

3750 Investors Ct
Grand Chute, WI 54913

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 7

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.

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1831652775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 INVESTORS CT",
            "city": "GRAND CHUTE",
            "state": "WI",
            "postal_code": "549132330",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMILTY",
        "first_name": "HANNAH",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "75245-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "htumilty309534@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "3750 Investors Ct",
            "city": "Grand Chute",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549132330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Chute, WI

Sources for this page

Verify at the official NPI Registry.