Maxwell Tanyi Fohtung

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

DR.0069226 Issued in CO

Practice address

4949 W Pine Blvd
Saint Louis, MO 63108

Phone

(314) 389-1496

NPI assigned

Jul 14, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, CO2 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

Specialty

General Surgery

Education

Indiana University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro Health One IncGroup PAC ID 2466778089, 27 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.44 of 100Reported as group

Quality

71.93

Promoting interoperability

100

Improvement activities

40

Cost

59.54

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pro Health One Inc

  • Surgery Physician
  • Denver, CO
  • NPI 1053714584
  Medicare reassignment Care Compare group
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Miramar, FL
  • NPI 1407146707

  MO

  Medicare reassignment NPD
• Vohra Wound Physicians of the West, P.C.

  • Family Medicine Physician
  • Englewood, CO
  • NPI 1205176096

  General Practice

  Medicare reassignment NPD
• Signify Health Medical Associates of Colorado, PLLC.

  • Multi-Specialty Clinic/Center
  • Denver, CO
  • NPI 1023625662

  General Practice

  NPD
• Vohra Wound Physicians of FL, LLC

  • Family Medicine Physician
  • Conyers, GA
  • NPI 1598061293

  General Practice

  NPD

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1982088571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 W PINE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081431",
            "telephone_number": "314-362-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 W PINE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63108",
            "telephone_number": "314-389-1496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101003",
            "country_code": "US",
            "telephone_number": "314-362-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOHTUNG",
        "first_name": "MAXWELL",
        "middle_name": "TANYI",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-14",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2018011353",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2018011353",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR.0069226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Martin Fogarty Jr., M.D.
• Leslie Abigail Fogel, MD
• Nicholas Fogle, NNP
• Mary Fogleman
• Kelsey Elise Fogus, CRNA
• Katherine Foizey, LPC
• Marcia S Foldes
• Amanda Foley
• Donna Nicole Foley
• Lillian Foley

• General Practice Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.