Individual provider Active NPI

John K Brendel Jr., M.D.

  • Interventional Pain Medicine Physician
  • Rice Lake, WI
National Provider Identifier
1073596052
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
34036-020 Issued in WI
Practice address
2021 Cenex Dr Unit J
Rice Lake, WI 54868-1892
Phone
(715) 234-7246
Fax
(715) 234-7242
NPI assigned
Nov 23, 2005
Last updated
Apr 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 34036-020 WI
Interventional Pain Medicine Physician 208VP0014X 34036-020 WI Primary

Addresses

Primary practice location

2021 Cenex Dr Unit J
Rice Lake, WI 54868-1892

Mailing address

2021 Cenex Dr Unit J
Rice Lake, WI 54868-1892
Phone (715) 234-7246

Other identifiers 1

IdentifierTypeStateIssuer
31913700MedicaidWI

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
I20040318000637 WI Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 9335038892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of Wisconsin School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2021 Cenex Dr
Unit J
Rice Lake, WI 54868-1892
Phone (715) 234-7246

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34036-020WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Specialists of Wisconsin, SC CurrentSince Jun 19, 1993 Accepting new patients
Interventional Pain Specialists of Wisconsin, SC CurrentSince Jun 19, 1993 Accepting new patients

Locations

401 Stageline Rd
Ste 2
Hudson, WI 54016
Phone (715) 234-7246

411 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

2021 Cenex Dr
Unit J
Rice Lake, WI 54868
Phone (715) 234-7246

Interoperability endpoints

  • Direct secure messaging: clinical@ipsw.directbygreenway.com
  • Direct secure messaging: john.brendel@cumberland-directmessage.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1073596052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 CENEX DR UNIT J",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681892",
            "telephone_number": "715-234-7246",
            "fax_number": "715-234-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 CENEX DR UNIT J",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681892",
            "telephone_number": "715-234-7246",
            "fax_number": "715-234-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENDEL",
        "first_name": "JOHN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "34036-020",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WI",
            "license": "34036-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31913700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.