New Medical Center, S.c. | |
160 Gateway Dr, Ste A Waupun WI 53963-2276 | |
(920) 324-9899 | |
(920) 324-9898 |
Full Name | New Medical Center, S.c. |
---|---|
Speciality | General Practice |
Location | 160 Gateway Dr, Ste A, Waupun, Wisconsin |
Authorized Official Name and Position | Randall L Blohowiak (PRESIDENT) |
Authorized Official Contact | 9203249899 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
New Medical Center, S.c. 160 Gateway Dr, Ste A Waupun WI 53963-2276 Ph: (920) 324-9899 | New Medical Center, S.c. 160 Gateway Dr, Ste A Waupun WI 53963-2276 Ph: (920) 324-9899 |
NPI Number | 1093368607 |
---|---|
Provider Enumeration Date | 07/23/2019 |
Last Update Date | 05/05/2022 |
Medicare PECOS PAC ID | 8022440973 |
---|---|
Medicare Enrollment ID | O20191114000095 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093368607 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Provider Name | Douglas S Yeatman |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1255314910 PECOS PAC ID: 8426023037 Enrollment ID: I20040827000618 |
Provider Name | Randall L Blohowiak |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1356301188 PECOS PAC ID: 1052346202 Enrollment ID: I20050928000348 |
Provider Name | Jennifer A Davis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619490711 PECOS PAC ID: 1456625763 Enrollment ID: I20170926002458 |
Provider Name | Seth D Tyberg |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1164695078 PECOS PAC ID: 2769554336 Enrollment ID: I20200601002216 |
Provider Name | Paige Ann Brockdorf |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790457638 PECOS PAC ID: 6305235243 Enrollment ID: I20211115000635 |
Provider Name | Nicole A Fields |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467119388 PECOS PAC ID: 2365834272 Enrollment ID: I20220126000527 |
Provider Name | Chelsea Kurtz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972247443 PECOS PAC ID: 5890172902 Enrollment ID: I20220511000917 |
Mariano L. Rosales Jr., M.d. S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Fern St, Waupun, WI 53963 Phone: 920-324-3559 Fax: 920-324-0258 | |
(inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Gateway Dr, Waupun, WI 53963 Phone: 920-345-1306 Fax: 920-345-1325 |