Thomas Tackman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30509 Issued in WI

Practice address

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

Phone

(920) 563-5571

Fax

(920) 563-7705

NPI assigned

Jun 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal MedicineAlso: General Surgery

Education

Medical College of Wisconsin, 1988

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)

Hospital & facility affiliations

• Commonheart Home Health Home health agency, Waukesha, WI, CCN 527151
• Rainbow Hospice Care Hospice, Jefferson, WI, CCN 521555
• Agrace Hospicecare Hospice, Madison, WI, CCN 521505
• Fort Memorial Hospital Hospital, Fort Atkinson, WI, CCN 520071
• University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361
  Medicare reassignment Care Compare group NPD
• Fort Healthcare Inc

  • Rural Health Clinic/Center
  • Fort Atkinson, WI
  • NPI 1417450115
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Agrace Hospicecare, Incorporated

  • Community Based Hospice Care Agency
  • Fitchburg, WI
  • NPI 1861503534
  Care Compare affiliation
• Commonheart, Inc.

  • Home Health Agency
  • Waukesha, WI
  • NPI 1629071121
  Care Compare affiliation
• Fort Healthcare Inc

  • Otolaryngology Physician
  • Fort Atkinson, WI
  • NPI 1417993361

  Hospital

  Care Compare affiliation
• Fort Healthcare, Inc.

  • General Acute Care Hospital
  • Fort Atkinson, WI
  • NPI 1811916281
  Care Compare affiliation
• Rainbow Hospice Care, Inc.

  • Community Based Hospice Care Agency
  • Jefferson, WI
  • NPI 1538134499
  Care Compare affiliation
• University of Wisconsin Hospitals and Clinics Authority

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1922043744
  Care Compare affiliation

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1902802416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535380249",
            "telephone_number": "920-563-5571",
            "fax_number": "920-563-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381960",
            "telephone_number": "920-563-5571",
            "fax_number": "920-563-7705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1461 W Main St",
            "address_purpose": "LOCATION",
            "city": "Whitewater",
            "state": "WI",
            "postal_code": "531901568",
            "country_code": "US",
            "telephone_number": "262-473-5888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKMAN",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "30509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Lee Suttinger, CST-CFA
• Swea Fort SC
• Catherine L Sweeney, MD
• Craig Sweeney, LPC-IT
• Jacob Edward Taber, DO
• Hilary Ann Tenge, PHARMD
• Rebecca Tenhoor, OTR/L
• Todd M Tesch, DC
• Thomas R. Perry, M.D.,S.C.
• Kelly Rae Toijala, PA

• Internal Medicine Physician in Fort Atkinson, WI
• Providers in Fort Atkinson, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.