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Individual provider Active NPI

James Patrick Fogarty, M.D.

  • Nurse Practitioner
  • Cameron, WI
National Provider Identifier
1881689891
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1673 Issued in WI
Practice address
902 West Main Street
Cameron, WI 54822-0144
Phone
(715) 458-3124
Fax
(715) 458-3125
NPI assigned
Sep 15, 2005
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1673 WI Primary
Surgery Physician 208600000X 18691 WI

Addresses

Primary practice location

902 West Main Street
Cameron, WI 54822-0144

Mailing address

P.O. Box 144
Cameron, WI 54822-0144
Phone (715) 458-3124

Other identifiers 1

IdentifierTypeStateIssuer
21288500MedicaidWI

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
I20040312000429 WI Practitioner - General Surgery 1759270200 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Wisconsin School of Medicine, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

902 W Main St
Cameron, WI 54822-4910
Phone (715) 458-3124

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.19 of 100Reported as group
Quality
74.89
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.05 of 100Reported as group
Quality
87.37
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions13
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18691WIMDPharmacist
1673WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ri-Lee Medical Staffing, Inc. Surgery CurrentSince Aug 1, 2005 Accepting new patients
Spooner Health System, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients
Cable Chiropractic Clinic, S.C. Past Accepting new patients

Locations

43570 Kavanaugh Rd
Cable, WI 54821
Phone (715) 798-3124

11128 N State Road 77
Hayward, WI 54843
Phone (715) 934-3124

1280 Chandler Dr
Spooner, WI 54801
Phone (715) 635-2111

Organizations & group practices 4

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1881689891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 144",
            "city": "CAMERON",
            "state": "WI",
            "postal_code": "548220144",
            "telephone_number": "715-458-3124",
            "fax_number": "715-458-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 WEST MAIN STREET",
            "city": "CAMERON",
            "state": "WI",
            "postal_code": "548220144",
            "telephone_number": "715-458-3124",
            "fax_number": "715-458-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGARTY",
        "first_name": "JAMES",
        "middle_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1673",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "18691",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21288500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, WI

Sources for this page

Verify at the official NPI Registry.