Individual provider Active NPI

Stan L Markus, MD

  • Surgery Physician
  • Oconomowoc, WI
National Provider Identifier
1134103641
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
28258 Issued in WI
Practice address
888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342
Phone
(262) 567-1499
Fax
(262) 567-4502
NPI assigned
Nov 30, 2005
Last updated
Nov 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 28258 WI Primary
Colon & Rectal Surgery Physician 208C00000X 28258 WI

Addresses

Primary practice location

888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342

Mailing address

888 Thackeray TRL Ste 103
Oconomowoc, WI 53066-4342
Phone (262) 567-1499

Other identifiers 1

IdentifierTypeStateIssuer
30821400MedicaidWI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050204000245 WI Practitioner - General Surgery 8426009697 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wright State University Boonshoft School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

1185 Corporate Ctr Dr
Oconomowoc, WI 53066-4888

1185 Corporate Ctr Dr
Suite 175
Oconomowoc, WI 53066-4889
Phone (262) 928-8400

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-1000

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue96
Removal of skin lesions61
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28258WIMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Dam Community Hospitals Inc CurrentSince Oct 19, 2017 Accepting new patients
Prohealth Medical Group Inc. Surgery CurrentSince Jan 1, 2019 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Feb 17, 2018 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Feb 17, 2018 Accepting new patients
Mercy Health System Corporation CurrentSince May 4, 2018 Accepting new patients
Mile Bluff Medical Center Inc Current Accepting new patients
Mercy Health System Corporation CurrentSince May 4, 2018 Accepting new patients
Beaver Dam Community Hospitals Inc Current Accepting new patients
M a Haroon, MD, PC PastSince May 15, 2016 Accepting new patients
Omega Home Medical Equipment, Inc Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

510 N Terrace St
Janesville, WI 53548
Phone (608) 756-6869

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

1185 Corporate Center Dr
Oconomowoc, WI 53066
Phone (262) 928-8400

1185 Corporate Center Dr
#2
Oconomowoc, WI 53066
Phone (262) 567-1499

888 Thackeray Trl
Ste 103
Oconomowoc, WI 53066
Phone (262) 287-2128

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

123 Hospital Dr
Ste 2000
Watertown, WI 53098
Phone (920) 206-3042

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

28 Commerce St
Wisconsin Dells, WI 53965
Phone (608) 254-5888

Interoperability endpoints

  • Direct secure messaging: smarkus14750@direct.phci.org

Organizations & group practices 11

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.

Hospital & facility affiliations 4

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1134103641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 103",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-567-1499",
            "fax_number": "262-567-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 THACKERAY TRL STE 103",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664342",
            "telephone_number": "262-567-1499",
            "fax_number": "262-567-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKUS",
        "first_name": "STAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "28258",
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "WI",
            "license": "28258",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30821400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.