Individual provider Active NPI

Males Mainviel, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Richland Center, WI
National Provider Identifier
1104651652
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16165-33 Issued in WI
Practice address
333 E 2ND St
Richland Center, WI 53581-1914
Phone
(608) 647-6321
NPI assigned
Sep 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16165-33 WI Primary

Addresses

Primary practice location

333 E 2ND St
Richland Center, WI 53581-1914

Mailing address

24959 Morris Valley Rd
Richland Center, WI 53581-6348
Phone (608) 639-0413

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110003274 WI Practitioner - Nurse Practitioner 6002344579 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland HospitalGroup PAC ID 7618861618, 69 clinicians

Practice addresses (Care Compare)

333 E 2ND St
Richland Center, WI 53581-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16165-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Hospital CurrentSince Dec 1, 2025 Accepting new patients
Richland Hospital CurrentSince Feb 1, 2025 Accepting new patients
Richland Hospital CurrentSince Feb 1, 2025 Accepting new patients
Richland Hospital Past Accepting new patients

Locations

1075 N Wisconsin Ave
Muscoda, WI 53573
Phone (608) 739-3113

333 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

301 E 2nd St
Richland Ctr, WI 53581
Phone (608) 647-6161

Organizations & group practices 4

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 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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1104651652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24959 MORRIS VALLEY RD",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535816348",
            "telephone_number": "608-639-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 2ND ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535811914",
            "telephone_number": "608-647-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINVIEL",
        "first_name": "MALES",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "16165-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland Center, WI

Sources for this page

Verify at the official NPI Registry.