| Darrin Antonelli, MD | |
|
610 W Adams St, Black River Falls, WI 54615-9010 | |
| (715) 284-4311 | |
| (715) 284-2568 |
| Full Name | Darrin Antonelli |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 31 Years |
| Location | 610 W Adams St, Black River Falls, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386673481 | NPI | - | NPPES |
| 32648400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 42121 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Black River Memorial Hospital | Black river falls, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Black River Health Inc | 3173431178 | 52 |
| Entity Name | Krohn Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790777621 PECOS PAC ID: 3577464916 Enrollment ID: O20040119000050 |
| Entity Name | Black River Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811940331 PECOS PAC ID: 3173431178 Enrollment ID: O20040128000517 |
| Entity Name | Black River Health 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 |
|---|---|
| Darrin Antonelli, MD 610 W Adams St, Black River Falls, WI 54615-9010 Ph: (715) 284-4311 | Darrin Antonelli, MD 610 W Adams St, Black River Falls, WI 54615-9010 Ph: (715) 284-4311 |
Dr. Nicholas Jerome Kitowski, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 610 W Adams St, Black River Falls, WI 54615 Phone: 715-284-4311 Fax: 715-284-0475 |