Individual provider Active NPI

Philip Richard Albert, M.D.

  • Diagnostic Radiology Physician
  • Wausau, WI
National Provider Identifier
1073619623
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
17796 Issued in WI
Practice address
2705 Rib Mountain Way
Wausau, WI 54401-9291
Phone
(715) 302-0130
Fax
(715) 842-4058
NPI assigned
Sep 14, 2006
Last updated
Feb 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 17796-020 WI
Diagnostic Radiology Physician 2085R0202X 17796 WI Primary

Addresses

Primary practice location

2705 Rib Mountain Way
Wausau, WI 54401-9291

Mailing address

2705 Rib Mountain Way
Wausau, WI 54401-9291
Phone (715) 302-0130

Other practice location 1

2500 Overlook Ter
Madison, WI 53705-2254
Phone (608) 280-7070

Other practice location 2

1836 South Ave
LA Crosse, WI 54601-5429
Phone (608) 782-7300

Other identifiers 1

IdentifierTypeStateIssuer
1073619623MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040614000081 WI Practitioner - Diagnostic Radiology 1052395647 Reassigns benefits to 10 organizations
I20200206000839 MN Practitioner - Diagnostic Radiology 1052395647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, shared by 16 NPIs, 888 clinicians
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

1122 W Hwy 61
Winona, MN 55987-1957
Phone (507) 615-0600

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

226 2ND St N
Lacrescent, MN 55947-1111
Phone (507) 895-6610

610 E Taylor St
PR Du Chien, WI 53821-2109
Phone (608) 326-6466

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17796-020WIMDBody Imaging Physician
17796WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Memorial Hospital, Inc. CurrentSince Feb 25, 2020 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Feb 20, 2020 Accepting new patients
Portage Radiology, SC Diagnostic Radiology CurrentSince May 6, 2019 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Dec 1, 2023 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Veterans Memorial Hospital City of Waukon Ia Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Feb 10, 2020 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Feb 25, 2020 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Feb 10, 2020 Accepting new patients
Vernon Memorial Healthcare, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Feb 18, 2020 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Feb 20, 2020 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc CurrentSince Feb 18, 2020 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Feb 10, 2020 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Feb 10, 2020 Accepting new patients
Palmer Lutheran Health Center, Inc. CurrentSince Apr 22, 2020 Accepting new patients
Tomah Memorial Hospital Inc Diagnostic Radiology CurrentSince Dec 1, 2023 Accepting new patients

Locations

40 1st St SE
Waukon, IA 52172
Phone (563) 568-3411

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

1122 W Highway 61
Winona, MN 55987
Phone (507) 615-0600

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

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

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

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

18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 7

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1073619623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 RIB MOUNTAIN WAY",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019291",
            "telephone_number": "715-302-0130",
            "fax_number": "715-842-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 RIB MOUNTAIN WAY",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019291",
            "telephone_number": "715-302-0130",
            "fax_number": "715-842-4058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Overlook Ter",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537052254",
            "country_code": "US",
            "telephone_number": "608-280-7070",
            "fax_number": "608-280-7283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1836 South Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546015429",
            "country_code": "US",
            "telephone_number": "608-782-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALBERT",
        "first_name": "PHILIP",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "WI",
            "license": "17796-020",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "17796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073619623",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.