Derrick Robson Siebert, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

61877 - 20 Issued in WI

Practice address

333 Pine Ridge Blvd
Wausau, WI 54401-4120

Phone

(715) 847-2283

NPI assigned

Jun 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Diagnostic Radiology

Education

Medical College of Wisconsin, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates of Wausau SCGroup PAC ID 7618869587, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
• Aspirus Medford Hospital & Clinics, Inc Hospital, Medford, WI, CCN 521324
• Aspirus Rhinelander Hospital Hospital, Rhinelander, WI, CCN 520019
• Langlade Hospital Hospital, Antigo, WI, CCN 521350
• Aspirus Riverview Hospital & Clinics Inc Hospital, Wisconsin Rapids, WI, CCN 520033

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Radiology Associates of Wausau, SC

  • Diagnostic Radiology Physician
  • Wausau, WI
  • NPI 1588679450
  Medicare reassignment Care Compare group NPD

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

• Aspirus Medford Hospital & Clinics, Inc.

  • Rehabilitation Clinic/Center
  • Medford, WI
  • NPI 1104922814

  Hospital

  Care Compare affiliation
• Aspirus Medford Hospital & Clinics, Inc.

  • Rehabilitation Hospital Unit
  • Prentice, WI
  • NPI 1154468205
  Care Compare affiliation
• Aspirus Medford Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Rib Lake, WI
  • NPI 1265502173

  Hospital

  Care Compare affiliation
• Aspirus Medford Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Gilman, WI
  • NPI 1285703173

  Hospital

  Care Compare affiliation
• Aspirus Medford Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Medford, WI
  • NPI 1427140649

  Hospital

  Care Compare affiliation
• Aspirus Medford Hospital & Clinics, Inc.

  • Critical Access Hospital
  • Medford, WI
  • NPI 1619079597
  Care Compare affiliation
• Aspirus Medford Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Prentice, WI
  • NPI 1710066584

  Hospital

  Care Compare affiliation
• Aspirus Medford Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Athens, WI
  • NPI 1760912919

  Hospital

  Care Compare affiliation
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc

  • Rural Health Clinic/Center
  • Rhinelander, WI
  • NPI 1598420218

  Hospital

  Care Compare affiliation
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Plover, WI
  • NPI 1053080168

  Hospital

  Care Compare affiliation
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Wittenberg, WI
  • NPI 1114696507

  Hospital

  Care Compare affiliation
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1063674224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1324",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544021324",
            "telephone_number": "414-559-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014120",
            "telephone_number": "715-847-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBERT",
        "first_name": "DERRICK",
        "middle_name": "ROBSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "61877 - 20",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": "61877 - 20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Shoptikal LLC
• Paul T Shore, DDS
• Joshua Shupe, MD
• Sarah Siekert, DNP, FNP-BC
• Julie Sigler Edmundson, MS.,LPC.,CSAC,ICS
• Melissa Sue Sigmund, AUD
• Mandy L Sikorski, APNP
• Jennie Simms

• Diagnostic Radiology Physician in Wausau, WI
• Providers in Wausau, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.