Ryan B Marendiuk, DNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

13689-33 Issued in WI

Practice address

430 E Division St
Fond Du Lac, WI 54935-4560

Phone

(920) 926-4200

Fax

(920) 926-8933

NPI assigned

Sep 29, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• River City Hospice, LLC

  • Community Based Hospice Care Agency
  • Post Falls, ID
  • NPI 1770719965
  NPD (past)

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1093965816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SSM HEALTH FDL REGIONAL CLINIC",
            "address_2": "1808 W BELTLINE HWY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537132334",
            "telephone_number": "608-250-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-4200",
            "fax_number": "920-926-8933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3726 E Mullan Ave",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838549852",
            "country_code": "US",
            "telephone_number": "208-777-2489",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 W Brown St",
            "address_purpose": "LOCATION",
            "city": "Waupun",
            "state": "WI",
            "postal_code": "539631702",
            "country_code": "US",
            "telephone_number": "920-324-7600",
            "fax_number": "920-324-8459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "845 Parkside St",
            "address_purpose": "LOCATION",
            "city": "Ripon",
            "state": "WI",
            "postal_code": "549718505",
            "country_code": "US",
            "telephone_number": "920-926-4200",
            "fax_number": "920-926-8933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARENDIUK",
        "first_name": "RYAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "HI",
            "license": "48298",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13689-33",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ID",
            "license": "27171",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "13689-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rmarendiuk447739@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rmarendiuk447739@direct-ehr-ssmhc.com",
            "address_1": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "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": "430 E Division St",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549354560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Manor Care of Fond Du Lac Wi LLC
• Manor of Fond Du Lac LLC
• Emily Jane Mans, PTA
• Johanna Manthey, LCSW
• Heidi Noelle Marendiuk, CRNA
• Joseph P Marik, MD
• Nancy Marik, PT
• Judy Carolyn Marschall, LPN
• Martin Chiropractic
• Gayle Ann Martin, DC

• Psychiatric/Mental Health Nurse Practitioner in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.