Individual provider Active NPI

Robert H Tambeaux, MD

  • Diagnostic Radiology Physician
  • Green Bay, WI
National Provider Identifier
1851447262
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
32383 Issued in WI
Practice address
2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone
(920) 336-4096
Fax
(920) 336-8093
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 32383 WI Primary

Addresses

Primary practice location

2941 S Ridge Rd
Green Bay, WI 54304-5517

Mailing address

2941 S Ridge Rd
Green Bay, WI 54304-5517
Phone (920) 336-4096

Other identifiers 1

IdentifierTypeStateIssuer
31727800MedicaidWI

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32383WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Del Norte Medical Imaging, Inc. Diagnostic Radiology Past Accepting new patients
Prevea Clinic, Inc. Past Accepting new patients
Prevea Regional Services, Inc. Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1851447262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045517",
            "telephone_number": "920-336-4096",
            "fax_number": "920-336-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBEAUX",
        "first_name": "ROBERT",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "32383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31727800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.