David Bruce Tick, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34022 Issued in WI

Practice address

216 Green Bay Rd Ste 109
Thiensville, WI 53092

Phone

(262) 241-5414

Fax

(262) 241-5425

NPI assigned

Mar 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Interpedia, S.C.

  • Clinic/Center
  • Thiensville, WI
  • NPI 1568432979

  WI

  Medicare reassignment Care Compare group NPD Authorized official
• Independent Physicians of Wisconsin, LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1871975920

  WI

  Medicare reassignment Care Compare group
• Midland Health Testing Services Inc

  • Public Health or Welfare Agency
  • Wauwatosa, WI
  • NPI 1700193935

  WI

  Medicare reassignment NPD

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

Rush Medical College of Rush University, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Physicians of Wisconsin LLC 42 clinicians

Interpedia SC 5 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1972571313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 GREEN BAY RD STE 109",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530921625",
            "telephone_number": "262-241-5414",
            "fax_number": "262-672-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 GREEN BAY RD STE 109",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-241-5414",
            "fax_number": "262-241-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICK",
        "first_name": "DAVID",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "34022",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "WI",
            "license": "34022",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "34022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110174900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "33540257",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31891200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "050577505014",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Conley Tack, DDS
• Joseph Tepp, DPT
• Thiensville Family Health Care SC
• Thurow Primary Preventive Healthcare, SC
• Sharon K Thurow, APNP
• Todd Tischer, RPH
• US Healthcenter, Inc.
• Via Therapy LLC
• Village of Thiensville
• Walgreen Co

• All providers in Thiensville, WI
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; 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.