Royle G Eenigenburg Jr., MD
Individual provider Active NPI Psychiatry Physician · Juneau, WI
NPI 1104858836 · NPPES record last updated Feb 8, 2017
Key facts
- NPI
- 1104858836
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 34504 (WI)
- Practice address
- 199 County Road DF
FL 3
Juneau, WI 53039-9512 - Phone
- (920) 386-4094
- Fax
- (920) 386-3812
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Rush Medical College of Rush University, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- County of Dodge
Psychiatric Services SC
Practice addresses (Care Compare)
199 County Rd DF
Juneau, WI 53039-9512
Phone (920) 386-4094
2727 Marshall CT
Madison, WI 53705-2255
Phone (608) 238-9354
Hospital & facility affiliations
- Marshfield Medical Center - Beaver Dam (MMC-BD)
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040927000349 | WI | Practitioner - Psychiatry | 4981673092 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34504 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric Services SC | Psychiatry | Current |
Accepting new patients |
Locations
2727 Marshall Ct
Madison, WI 53705
Phone (608) 238-9354
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 34504 | WI | Yes |
Addresses
Primary practice location
199 County Road DF
FL 3
Juneau, WI 53039-9512
Mailing address
199 County Road DF
FL 3
Juneau, WI 53039-9512
Phone (920) 386-4094
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31968600 | Medicaid | WI |
Other providers in Juneau, WI
- Dodge County Medical Facilities
- Dodge County Medical Facilities
- Dodgeland School District
- David John Dreyer
- Sarah J Duffy
- Doreen Kay Eicher
- Sandra Jean Eichmann
- Taryn Elizabeth Evans Dreyer
- Ann Marie Falkinham
- Jason E Flanders
All providers in Juneau, WI · Psychiatry Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.