Manuel A Mendoza, MD | |
1405 Mill St, New London, WI 54961-2155 | |
(920) 531-2000 | |
(920) 531-2030 |
Full Name | Manuel A Mendoza |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 1405 Mill St, New London, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740269158 | NPI | - | NPPES |
32248400 | Medicaid | WI | |
1009390 | Other | WI | PHYS PLUS PROV # |
70 | Other | WI | DEANCARE PROV # |
930117017 | Other | WI | RAILROAD MEDICARE PROV # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 387187-020 (Wisconsin) | Secondary |
207P00000X | Emergency Medicine | 38187 (Wisconsin) | Primary |
Entity Name | Thedacare Medical Center - Shawano, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548260839 PECOS PAC ID: 5890605836 Enrollment ID: O20031117000117 |
Entity Name | Sauk Prairie Healthcare Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861466153 PECOS PAC ID: 8224948054 Enrollment ID: O20031208000206 |
Entity Name | Thedacare Medical Center - Berlin Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760413777 PECOS PAC ID: 0446151666 Enrollment ID: O20040120000214 |
Entity Name | Black River Memorial Hospital Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1811940331 PECOS PAC ID: 3173431178 Enrollment ID: O20040128000517 |
Entity Name | Thedacare Medical Center - New London, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538127220 PECOS PAC ID: 5698664480 Enrollment ID: O20040311000254 |
Entity Name | Thedacare Medical Center - Waupaca, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780782680 PECOS PAC ID: 3072504216 Enrollment ID: O20040524000645 |
Entity Name | Ascension Calumet Hospital Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376541748 PECOS PAC ID: 7416948427 Enrollment ID: O20040809000191 |
Entity Name | Black River Memorial Hospital Inc |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1811940331 PECOS PAC ID: 3173431178 Enrollment ID: O20061104000654 |
Mailing Address | Practice Location Address |
---|---|
Manuel A Mendoza, MD 707 14th St, Baraboo, WI 53913-1539 Ph: (608) 356-1400 | Manuel A Mendoza, MD 1405 Mill St, New London, WI 54961-2155 Ph: (920) 531-2000 |
Ronald J Krajnik, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2021 | |
Shawn S Williamson, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2021 | |
Amber Lievens Widenski, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2030 | |
Jocko R Zifferblatt, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2000 | |
Dr. John A Watring, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2000 | |
Carolyn A Hellman, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2000 Fax: 920-531-2098 | |
Jacob Kream, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2021 |