Aspirus Medical Group, Inc.
Organization Active NPI Clinic/Center · Wausau, WI
NPI 1053548693 · NPPES record last updated Feb 26, 2026
Key facts
- NPI
- 1053548693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ASPIRUS MEDICAL GROUP, INC.
- Practice address
- 425 Pine Ridge Blvd
Suite 220a
Wausau, WI 54401-4123 - Phone
- (715) 847-2070
- NPI assigned
- Jun 22, 2009
- Organization subpart
- Yes
- Parent organization (as reported)
- ASPIRUS MEDICAL GROUP, INC.
Authorized official
- Name
- Lori Peck
- Title
- SVP- Chief Financial Officer
- Phone
- (715) 847-2575
Corporate family (same tax ID) 23
Practitioners 7
-
Jenna Lee Kolodziej, D,O
-
Imona Subedi, M.B.B.S
-
Jayanna Volm, APNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000267 | WI | Part B Supplier - Clinic/Group Practice | 1052223625 |
Receives reassigned benefits from 484 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Aspirus Clinic Pharmacy
- Part of
- Aspirus Clinic Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | |||
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
425 Pine Ridge Blvd
Suite 220a
Wausau, WI 54401-4123
Mailing address
29980 Network PL
Chicago, IL 60673-1299
Phone (715) 847-2304
Other names
- Aspirus Endocrinology Clinic
- Aspirus Clinics Inc
Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.