Aanders Jarl Dommer, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

54943 Issued in WI

Practice address

1615 Maple Lane
Ashland, WI 54806

Phone

(715) 685-5500

Fax

(715) 682-4022

NPI assigned

Aug 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hisdept@direct.cloquethospital.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Hospice of Minnesota, LLC

  • Community Based Hospice Care Agency
  • Hermantown, MN
  • NPI 1073177986

  Contracted Managing Employee

  CMS ownership

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.

• Memorial Medical Center Inc

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Medicare reassignment NPD
• Community Memorial Hospital Association

  • Critical Access Hospital
  • Cloquet, MN
  • NPI 1003869082
  Medicare reassignment NPD
• Memorial Medical Center Inc

  • Rural Health Clinic/Center
  • Ashland, WI
  • NPI 1770255937
  NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
  • NPI 1700837812
  NPD (past)
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  NPD (past)
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Osseo, WI
  • NPI 1912958026
  NPD (past)
• Community Memorial Hospital Association

  • Dialysis Equipment & Supplies (DME)
  • Cloquet, MN
  • NPI 1528103652
  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1134311541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LANE",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "54806",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LANE",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "54806",
            "telephone_number": "715-685-5500",
            "fax_number": "715-682-4022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMMER",
        "first_name": "AANDERS",
        "middle_name": "JARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-10",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "50811",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "54943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hisdept@direct.cloquethospital.com",
            "affiliation": "N",
            "address_1": "512 Skyline Blvd Ste 1",
            "city": "Cloquet",
            "state": "MN",
            "country_code": "US",
            "postal_code": "557201199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leah A. Danner, M.D.
• Lori Anne Decarlo-Kienitz, CSAC
• Benjamin Vincent Deitzen, APRN, FNP-C
• Russell John Denomie
• Adrianna Digirolamo, LCSW
• Megan M Douglas, RHD
• Jessica A. Edelmann, MPT
• Jenelle Elza
• ENT Professional Associates SC
• Ann F Esala, DENTAL HYGIENIST

• Family Medicine Physician in Ashland, WI
• Providers in Ashland, 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 May 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.