Active NPI
Rachael E. Vanden Langenberg, D.O.
- Family Medicine Physician
- Green Bay, WI
National Provider Identifier
1003127465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 61517-21
- Practice address
- 3263 Eaton Rd
Green Bay, WI 54311-6830 - Phone
- (920) 433-6700
- NPI assigned
- Jun 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | OT013624 | PA | |
| Family Medicine Physician | 207Q00000X | OS015861 | PA | |
| Family Medicine Physician | 207Q00000X | 61517-21 | WI | Primary |
Addresses
Primary practice location
3263 Eaton Rd
Green Bay, WI 54311-6830
Mailing address
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61517-21 | Other | WI | STATE LICENSE |
Other names 1
- Dr. Rachael E. Mahoney
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700
Hospital & facility affiliations
- Bellin Home Health Agency
- Unity Hospice
- Bellin Memorial Hospital
- Rennes Health and Rehab Center-De Pere
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT013624 | PA | MD | Family Medicine Physician |
| 61517-21 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
Locations
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817
3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000
Interoperability endpoints
- rvandenlangenberg917145@direct.emplifyhealth.org
- rvandenlangenberg66503@direct.thedacare.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
-
- Clinic/Center
- Green Bay, WI
- NPI 1497191951
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Green Bay, WI
- NPI 1831246404
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1891740585
-
- Community Based Hospice Care Agency
- De Pere, WI
- NPI 1194797910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394064000000",
"number": "1003127465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3263 EATON RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543116830",
"telephone_number": "920-433-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3263 EATON RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543116830",
"telephone_number": "920-433-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEN LANGENBERG",
"first_name": "RACHAEL",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2014-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OT013624",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "OS015861",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "61517-21",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "61517-21",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RACHAEL",
"last_name": "MAHONEY",
"middle_name": "E.",
"prefix": "DR.",
"credential": "D.O.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.