Tomah Memorial Hospital Inc
Organization Active NPI Critical Access Hospital · Tomah, WI
NPI 1992970453 · NPPES record last updated Jun 9, 2026
Key facts
- NPI
- 1992970453
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- Legal business name
- TOMAH MEMORIAL HOSPITAL INC
- Practice address
- 501 Gopher Dr
Tomah, WI 54660-4513 - Phone
- (608) 372-2181
- NPI assigned
- Apr 25, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- TOMAH MEMORIAL HOSPITAL INC
Authorized official
- Name
- Derek Daly
- Title
- Ceo
- Phone
- (608) 377-8680
Parent organization (reported in NPPES) 1
Other NPIs with the same Medicare PAC ID 3
Practitioners 266
-
Mateen Fatima Abidi, M.D
-
Raju G Ailiani, MD
-
Timothy Andrew Bernauer, M.D.
-
Robyn Lynn Brown, NP
-
Tiffany N Casper, DO
-
Karyn Cecele, M.D.
-
Timothy S Chen, M.D.
-
Gerald Dennis Fushianes, PA-C
-
Keyvan Gharabeighlou, D.O.
-
Grzegorz T Gurda, MD, PHD
-
John W Haeberlin, M.D.
-
Wah Wah Htun, M.D
-
Jamal Janjua, M.D
-
Patricia Jo Jennings, CRNA
-
Diana Johnson, CRNA
-
Ivan Kaspruk, MD
-
Andrew Last, MD
-
Sharel A Martin, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040519000123 | WI | Part B Supplier - Clinic/Group Practice | 6901897016 |
Receives reassigned benefits from 257 practitioners Practice locations: Tomah, WI |
National Provider Directory
- Part of
- Tomah Memorial Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| General Acute Care Hospital | 282N00000X | |||
| Critical Access Hospital | 282NC0060X | Yes |
Addresses
Primary practice location
501 Gopher Dr
Tomah, WI 54660-4513
Mailing address
501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32766100 | Medicaid | WI |
Other names
- Tomah Health
Other providers in Tomah, WI
- Tomah Memorial Hospital Inc
- Tomah Memorial Hospital Inc
- Tomah Memorial Hospital Inc
- Tomah Memorial Hospital Inc
- Tomah Memorial Hospital Inc
- Tomah Memorial Hospital, Inc.
- Tomah Therapy Center, LLC
- Tomah VA Medical Center
- Tomah VA Medical Center
- Tomah Vamc
All providers in Tomah, WI · Critical Access Hospital in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.