Individual provider Active NPI

Thomas George, M.D.

  • Hospitalist Physician
  • Fort Atkinson, WI
National Provider Identifier
1922448018
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
21653-875 Issued in WI
Practice address
611 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone
(920) 568-5000
NPI assigned
Jul 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 21653-875 WI Primary
Internal Medicine Physician 207R00000X 125064028 IL
Hospitalist Physician 208M00000X 036140741 IL

Addresses

Primary practice location

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

Mailing address

PO Box 249
Fort Atkinson, WI 53538-0249
Phone (920) 563-4466

Other identifiers 1

IdentifierTypeStateIssuer
125064028OtherILPHYSICIAN TEMPORARY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160808001566 IL Practitioner - Internal MedicinePractitioner - Hospitalist 5294029666 Reassigns benefits to 4 organizations
I20220209002359 WI Practitioner - Internal Medicine 5294029666 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
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 Sherman Ave E
Fort Atkinson, WI 53538-1960
Phone (920) 568-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125064028ILMDInternal Medicine Physician
036140741ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Current Accepting new patients
Proctor Health Systems CurrentSince Sep 3, 2019 Accepting new patients
24 On Physicians, PC Hospitalist CurrentSince Jul 15, 2016 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 3, 2019 Accepting new patients
Proctor Health Systems Internal Medicine Current Accepting new patients
Fort Healthcare Inc CurrentSince Jan 31, 2022 Accepting new patients
Pekin Prohealth Inc Internal Medicine CurrentSince Sep 3, 2019 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Sep 3, 2019 Accepting new patients
Proctor Health Systems CurrentSince Sep 3, 2019 Accepting new patients
Fort Healthcare Inc Current Accepting new patients
24 On Physicians, P.C. Hospitalist CurrentSince Jul 15, 2016 Accepting new patients

Locations

1100 E Norris Dr
Ottawa, IL 61350
Phone (815) 416-1224

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

221 NE Glen Oak Ave
Ste 514W
Peoria, IL 61636
Phone (309) 672-5733

815 Main St
Ste A1
Peoria, IL 61602

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

925 West St
Peru, IL 61354
Phone (815) 223-3300

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

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

Interoperability endpoints

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

Organizations & group practices 11

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 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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1922448018",
    "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": "920-563-4466"
        },
        {
            "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": "920-568-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "21653-875",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125064028",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036140741",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN TEMPORARY LICENSE",
            "identifier": "125064028",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

Verify at the official NPI Registry.