Individual provider Active NPI

Melissa R Themar Geck, MD

  • Diagnostic Radiology Physician
  • St Francis, WI
National Provider Identifier
1861641565
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
63372 Issued in WI
Practice address
2000 E Layton Ave
St Francis, WI 53235-6053
Phone
(414) 744-6589
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME103402 FL
Diagnostic Radiology Physician 2085R0202X 63372 WI Primary

Addresses

Primary practice location

2000 E Layton Ave
St Francis, WI 53235-6053

Mailing address

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

Other practice location 1

529 E Central Ave
Winter Haven, FL 33880-3054
Phone (863) 299-1155

Other practice location 2

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Other identifiers 1

IdentifierTypeStateIssuer
100042732MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mthemargeck144268@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
I20150320000286 WI Practitioner - Diagnostic Radiology 0042496432 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

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

3540 S 43Rd St
Milwaukee, WI 53220-1502
Phone (414) 541-1000

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
63372WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Mar 9, 2015 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2016 Accepting new patients
Aurora Medical Group, Inc. Diagnostic Radiology Current Accepting new patients
Lakeshore Medical Clinic LTD CurrentSince Mar 9, 2015 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Mar 9, 2015 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Mar 9, 2015 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jan 1, 2016 Accepting new patients

Locations

112 N US Highway 141
Crivitz, WI 54114
Phone (715) 735-6621

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

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

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

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

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

2801 W Kinnickinnic River Pkwy
Ste 250
Milwaukee, WI 53215
Phone (414) 649-3354

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

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

3540 S 43rd St
Milwaukee, WI 53220
Phone (414) 541-1000

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mthemargeck144268@direct.myadvocateaurora.org

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 3

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1861641565",
    "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": "2000 E LAYTON AVE",
            "city": "ST FRANCIS",
            "state": "WI",
            "postal_code": "532356053",
            "telephone_number": "414-744-6589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "529 E Central Ave",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338803054",
            "country_code": "US",
            "telephone_number": "863-299-1155",
            "fax_number": "863-299-1177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549047668",
            "country_code": "US",
            "telephone_number": "920-303-8700",
            "fax_number": "920-303-5630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEMAR GECK",
        "first_name": "MELISSA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME103402",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "63372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100042732",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mthemargeck144268@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "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": "855 N Westhaven Dr",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549047668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Francis, WI

Sources for this page

Verify at the official NPI Registry.