| 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 | Randall L Blohowiak |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356301188 PECOS PAC ID: 1052346202 Enrollment ID: I20050928000348 |
| Provider Name | Seth D Tyberg |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1164695078 PECOS PAC ID: 2769554336 Enrollment ID: I20200601002216 |
| Provider Name | Bronwyn Hutchinson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1275132177 PECOS PAC ID: 2163833203 Enrollment ID: I20201123000682 |
| 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 |
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 | |
Beaver Dam Community Hospitals Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 Gateway Dr, Waupun, WI 53963 Phone: 920-345-1306 Fax: 920-345-1325 | |
Wound Care Of Wisconsin Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 160 Gateway Dr, Waupun, WI 53963 Phone: 920-324-9899 |