DR. DAVID TAN MCDOUGAL (DO) – Anesthesiology Physician, NPI 1104404136
Anesthesiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,266 ANESTHESIOLOGY in WI
Provider Addresses for DR. DAVID TAN MCDOUGAL (DO)
515 22nd Ave
Monroe, WI 535661569
Phone: (608) 324-2000
Type: Location
7160 Rafael Rivera Way Ste 210
Las Vegas, NV 891135395
Phone: (702) 878-0070
Fax: (702) 805-0307
Type: Location
PO BOX 840857
DALLAS, TX 752840857
Phone: (725) 204-4632
Fax: (702) 805-0307
Type: Mailing
11750 SW 40TH ST
MIAMI, FL 331753530
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-09-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250707002180 | I | Anesthesiology | WI | TBD |
| I20250915003680 | I | Anesthesiology | NV | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53566)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| - | WI | |
| Clinical Psychologist | WI | |
| - | WI | |
| P A T H O L O G Y | IL | |
| - | LA | |
| Emergency Medicine | WI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WI | |
| Nurse Practitioner | WI | |
| - | WI |
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