| Michael R Magoline, MD | |
|
421 Camelot Dr, Fond Du Lac, WI 54935-8335 | |
| (920) 926-8616 | |
| (920) 926-8098 |
| Full Name | Michael R Magoline |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 33 Years |
| Location | 421 Camelot Dr, Fond Du Lac, 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 |
|---|---|---|---|
| 1154412302 | NPI | - | NPPES |
| 2187002 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 35-071501 (Ohio) | Secondary |
| 207X00000X | Orthopaedic Surgery | 82106-20 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Agnes Hospital | Fond du lac, WI | Hospital |
| Ripon Medical Center | Ripon, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Agnesian Healthcare Inc | 1658289624 | 360 |
| Entity Name | Agnesian Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346228541 PECOS PAC ID: 1658289624 Enrollment ID: O20031104000263 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R Magoline, MD 1808 W Beltline Hwy, Ssm Health Fdlregional Clinic Attn: Nancy Pierce, Madison, WI 53713-2334 Ph: (920) 926-8343 | Michael R Magoline, MD 421 Camelot Dr, Fond Du Lac, WI 54935-8335 Ph: (920) 926-8616 |
Alan W Roetker, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Benjamin Richard Wiseley, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Glen J Kemp Jr., MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 Fax: 920-926-8098 | |
Karl Pennau, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Michael D Mannebach, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 | |
Dr. Clark Pomeroy Searle Iii, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 421 Camelot Dr, Fond Du Lac, WI 54935 Phone: 920-926-8616 |