Individual provider Active NPI

Gislaine Tsemo, MD

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1851351068
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33889 Issued in AZ
Practice address
9201 W Thomas Rd
Phoenix, AZ 85037-3332
Phone
(623) 327-7313
Fax
(623) 327-5437
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33889 AZ Primary

Addresses

Primary practice location

9201 W Thomas Rd
Phoenix, AZ 85037-3332

Mailing address

PO Box 708850
Sandy, UT 84070-8850
Phone (866) 869-2395

Other identifiers 3

IdentifierTypeStateIssuer
975980MedicaidAZ
P003J6264OtherAZRR MEDICARE
AZ0781010OtherAZBCBS

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
I20081017000195 WI Practitioner - Internal Medicine 1456388750 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Healthcare IncGroup PAC ID 0840189718, 159 clinicians

Practice addresses (Care Compare)

611 E Sherman Ave
Fort Atkinson, WI 53538-1960
Phone (920) 568-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33889AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Fort Healthcare Inc CurrentSince Nov 11, 2016 Accepting new patients
Fort Healthcare Inc CurrentSince Nov 11, 2016 Accepting new patients
Oak Medical SC Internal Medicine CurrentSince Sep 15, 2019 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
The Medical College of Wisconsin, Inc. Internal Medicine CurrentSince Jul 1, 2010 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Aug 1, 2016 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

512 Wilcox St
Fort Atkinson, WI 53538
Phone (920) 563-7366

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

130 2nd St
Ste 197
Neenah, WI 54956
Phone (920) 729-2030

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

N20W22961 Watertown Rd
Waukesha, WI 53186
Phone (262) 875-5070

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/
  • Direct secure messaging: gislaine.tsemo@direct.forthc.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1851351068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708850",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708850",
            "telephone_number": "866-869-2395",
            "fax_number": "801-352-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373332",
            "telephone_number": "623-327-7313",
            "fax_number": "623-327-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSEMO",
        "first_name": "GISLAINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "975980",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P003J6264",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0781010",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.