Individual provider Active NPI

Diana V Flint, M.D

  • Family Medicine Physician
  • Sun Prairie, WI
National Provider Identifier
1053678730
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
66953-20 Issued in WI
Practice address
10 Tower Dr
Sun Prairie, WI 53590-1239
Phone
(608) 825-3500
Fax
(608) 825-3786
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 66953-20 WI Primary

Addresses

Primary practice location

10 Tower Dr
Sun Prairie, WI 53590-1239

Mailing address

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

Other practice location 1

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

Other practice location 2

130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone (920) 887-3102

Other identifiers 1

IdentifierTypeStateIssuer
1053678730MedicaidWI

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address dflint262614@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address dflint262614@direct-ehr-ssmhc.com Direct AGNESIAN HEALTHCARE INC
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other AGNESIAN HEALTHCARE INC

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
I20170918000767 WI Practitioner - Family Practice 1557588019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

Hospital & facility affiliations

  • SSM Health at Home Home Health-Wisconsin Home health agency, Madison, WI, CCN 527184
  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
  • Columbus Community Hospital Hospital, Columbus, WI, CCN 521338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
66953-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare Inc CurrentSince Mar 4, 2022 Accepting new patients
Dean Health Systems, Inc Family Medicine CurrentSince Aug 28, 2017 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc Family Medicine CurrentSince Mar 4, 2022 Accepting new patients
Dean Health Systems, Inc. CurrentSince Aug 28, 2017 Accepting new patients

Locations

130 Corporate Dr
Beaver Dam, WI 53916
Phone (920) 877-3102

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

10 Tower Dr
Sun Prairie, WI 53590
Phone (608) 825-3008

Interoperability endpoints

  • Direct secure messaging: dflint262614@direct-ehr-ssmhc.com

Organizations & group practices 5

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 5

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1053678730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TOWER DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901239",
            "telephone_number": "608-825-3500",
            "fax_number": "608-825-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TOWER DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901239",
            "telephone_number": "608-825-3500",
            "fax_number": "608-825-3786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Tower Dr",
            "address_purpose": "LOCATION",
            "city": "Sun Prairie",
            "state": "WI",
            "postal_code": "535901239",
            "country_code": "US",
            "telephone_number": "608-825-3500",
            "fax_number": "608-825-3786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Corporate Dr",
            "address_purpose": "LOCATION",
            "city": "Beaver Dam",
            "state": "WI",
            "postal_code": "539163116",
            "country_code": "US",
            "telephone_number": "920-887-3102",
            "fax_number": "920-885-8790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLINT",
        "first_name": "DIANA",
        "middle_name": "V",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "66953-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053678730",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dflint262614@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dflint262614@direct-ehr-ssmhc.com",
            "address_1": "10 Tower Dr",
            "city": "Sun Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535901239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "10 Tower Dr",
            "city": "Sun Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535901239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dflint262614@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dflint262614@direct-ehr-ssmhc.com",
            "address_1": "130 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "AGNESIAN HEALTHCARE INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "130 Corporate Dr",
            "city": "Beaver Dam",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539163116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

Verify at the official NPI Registry.