Dr Vasilisa Mironovich, MD | |
2817 New Pinery Rd, Portage, WI 53901-9240 | |
(608) 742-4131 | |
(608) 745-6393 |
Full Name | Dr Vasilisa Mironovich |
---|---|
Gender | Female |
Speciality | Family Practice |
Experience | 14 Years |
Location | 2817 New Pinery Rd, Portage, Wisconsin |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295024479 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 60837-20 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Divine Savior Healthcare | Portage, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Divine Savior Healthcare Inc | 5799684007 | 76 |
Entity Name | Divine Savior Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124083894 PECOS PAC ID: 5799684007 Enrollment ID: O20040225000909 |
Mailing Address | Practice Location Address |
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Dr Vasilisa Mironovich, MD 2817 New Pinery Rd, Portage, WI 53901-9240 Ph: (608) 742-4131 | Dr Vasilisa Mironovich, MD 2817 New Pinery Rd, Portage, WI 53901-9240 Ph: (608) 742-4131 |
Kelly Coker, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 2817 New Pinery Rd, Portage, WI 53901 Phone: 608-745-5145 | |
Richard J Qualy, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2977 County Hwy Cx, Portage, WI 53901 Phone: 608-742-3004 Fax: 608-742-2399 | |
Gerald L Krumpos, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2825 Hunters Trl, Portage, WI 53901 Phone: 608-742-7161 Fax: 608-745-3060 | |
Dr. Jamie John Kling, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2977 County Hwy Cx, Portage, WI 53901 Phone: 608-742-3004 Fax: 608-742-2399 | |
Dr. Sarah M Haroldson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2825 Hunters Trl, Portage, WI 53901 Phone: 608-742-7161 Fax: 608-745-3990 | |
David D Gregory, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2825 Hunters Trl, Portage, WI 53901 Phone: 608-724-7161 Fax: 608-745-3060 |