Individual provider Active NPI

Paul C. Mariskanish, MD

  • Emergency Medicine Physician
  • Prairie Du Chien, WI
National Provider Identifier
1003883976
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
41656 Issued in WI
Practice address
37868 US Highway 18
Prairie Du Chien, WI 53821-8416
Phone
(608) 357-2430
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 41656 WI Primary

Addresses

Primary practice location

37868 US Highway 18
Prairie Du Chien, WI 53821-8416

Mailing address

37868 US Highway 18
Prairie Du Chien, WI 53821-8416
Phone (608) 357-2430

Other practice location 1

315 W Main St
Platteville, WI 53818-3132
Phone (608) 778-5556

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address pmariskanish18924@direct.monroeclinic.org Direct The Monroe Clinic, Inc.
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Direct
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other

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
I20040514000513 WI Practitioner - Family Practice 0749270411 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41656WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Boscobel CurrentSince Apr 1, 2010 Accepting new patients
Prairie Du Chien Memorial Hospital Association Inc CurrentSince Mar 1, 2020 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Apr 1, 2010 Accepting new patients

Locations

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112

37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101

Interoperability endpoints

  • Direct secure messaging: pmariskanish733510@direct.emplifyhealth.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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1003883976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37868 US HIGHWAY 18",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538218416",
            "telephone_number": "608-357-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37868 US HIGHWAY 18",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538218416",
            "telephone_number": "608-357-2430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W Main St",
            "address_purpose": "LOCATION",
            "city": "Platteville",
            "state": "WI",
            "postal_code": "538183132",
            "country_code": "US",
            "telephone_number": "608-778-5556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARISKANISH",
        "first_name": "PAUL",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "41656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmariskanish18924@direct.monroeclinic.org",
            "affiliation": "Y",
            "affiliationName": "The Monroe Clinic, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "pmariskanish18924@direct.monroeclinic.org",
            "address_1": "515 22nd Avenue",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "address_1": "37868 US Highway 18",
            "city": "Prairie Du Chien",
            "state": "WI",
            "country_code": "US",
            "postal_code": "538218416",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "37868 US Highway 18",
            "city": "Prairie Du Chien",
            "state": "WI",
            "country_code": "US",
            "postal_code": "538218416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prairie Du Chien, WI

Sources for this page

Verify at the official NPI Registry.