Izabela J Ditchen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

45158 Issued in WI

Practice address

2714 Riverview Dr
Green Bay, WI 54313-6715

Phone

(920) 430-4760

NPI assigned

Dec 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Family Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unity Hospice Hospice, De Pere, WI, CCN 521503
• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
• Rennes Health and Rehab Center-De Pere Nursing home, De Pere, WI, CCN 525573

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iditchen29925@direct.thedacare.org
• Direct secure messaging: iditchen916797@direct.emplifyhealth.org

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473

  Family Medicine, WI

  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390

  Family Medicine

  NPD
• Bellin Memorial Hospital Inc

  • Neurology Physician
  • Green Bay, WI
  • NPI 1225420664
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784

  Family Medicine

  NPD (past)

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

• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585

  Hospital

  Care Compare affiliation
• TDR Inc

  • Skilled Nursing Facility
  • De Pere, WI
  • NPI 1932107422

  Nursing home

  Care Compare affiliation
• Unity Limited Partnership

  • Community Based Hospice Care Agency
  • De Pere, WI
  • NPI 1194797910

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1104800911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2714 RIVERVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543136715",
            "telephone_number": "920-430-4760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135753",
            "country_code": "US",
            "telephone_number": "920-430-4700",
            "fax_number": "920-430-4747",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-3500",
            "fax_number": "920-445-7301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITCHEN",
        "first_name": "IZABELA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-05",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "45158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34321800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "45158",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Dietze-Fiedler, M.D.
• Eileen Diller, APSW
• Dimensions Living Green Bay, LLC
• Sarah Katherine Dimezza, MD
• Kirk D Dimitris, MD
• Ditty Chiropractic, LLC
• Marc David Ditty, D.C.
• Jacqueline DO, DO
• Abigail Dobbins, SLP
• Brian Dale Dobbins, MD

• Family Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.