Individual provider Active NPI

John F Nielsen, M.D.

  • Family Medicine Physician
  • Marinette, WI
National Provider Identifier
1003811415
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75212-20 Issued in WI
Practice address
4061 Old Peshtigo Rd
Marinette, WI 54143-3887
Phone
(715) 732-8050
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J8333 TX
Family Medicine Physician 207Q00000X 75212-20 WI Primary

Addresses

Primary practice location

4061 Old Peshtigo Rd
Marinette, WI 54143-3887

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

702 Davis St
Ste 4
Carthage, TX 75633-1461
Phone (903) 694-4991

Other identifiers 3

IdentifierTypeStateIssuer
099875903MedicaidTX
8G9170OtherTXBLUE CROSS
100170914MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jnielsen411374@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624003412 WI Practitioner - Family Practice 1254526072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

4061 Old Peshtigo Rd
Marinette, WI 54143-3887
Phone (715) 732-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.56 of 100Reported as group
Quality
87.43
Promoting interoperability
100
Improvement activities
40
Cost
78.24

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75212-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Networks

  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • IL HMO C-SNP
  • IL PPO Downstate

Interoperability endpoints

  • Direct secure messaging: jnielsen411374@direct.myadvocateaurora.org

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1003811415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4061 OLD PESHTIGO RD",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541433887",
            "telephone_number": "715-732-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 Davis St",
            "address_2": "Ste 4",
            "address_purpose": "LOCATION",
            "city": "Carthage",
            "state": "TX",
            "postal_code": "756331461",
            "country_code": "US",
            "telephone_number": "903-694-4991",
            "fax_number": "903-694-4995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J8333",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "75212-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099875903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8G9170",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100170914",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jnielsen411374@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4061 Old Peshtigo Rd",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433887",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "4061 Old Peshtigo Rd",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541433887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.