Kelsey Kienert, M.D.
Individual provider Active NPI Internal Medicine Physician · Neenah, WI
NPI 1134501190 · NPPES record last updated Feb 21, 2024
Key facts
- NPI
- 1134501190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 68772 (WI)
- Practice address
- 101 Main St
Neenah, WI 54956 - Phone
- (920) 720-1463
- NPI assigned
- Jun 25, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 14
Owned or controlled facilities with NPI records 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Ascension Medical Group-Fox Valley Wisconsin, Inc
Practice addresses (Care Compare)
101 Main St
Neenah, WI 54956-2570
Phone (920) 727-4200
Hospital & facility affiliations
- Compassus Green Bay
- Compassus Neenah
- St Paul Hospice Services
- Moments Hospice of Appleton
- Ascension NE Wisconsin - St Elizabeth Campus
- Thedacare Regional Med Ctr - Neenah
- Bethel Home
- St Paul Elder Services, Inc
- Evergreen Health Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
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
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Wiplfi, LLP |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Oct 1, 2024 Oct 1, 2024 |
| Compassus-Green Bay |
Hospice | Contracted Managing Employee | Apr 5, 2021 |
| Compassus - Neenah |
Hospice | Contracted Managing Employee | Apr 5, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180822003189 | WI | Practitioner - Internal Medicine | 9931412814 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tapestry Telehealth PLLC | Internal Medicine | Current |
Accepting new patients |
| Ascension Medical Group-Fox Valley Wisconsin, Inc | Current |
Accepting new patients | |
| Ascension Medical Group-Fox Valley Wisconsin, Inc | Current |
Accepting new patients | |
| Iowa Physicians Clinic Medical Foundation | Internal Medicine | Past | Accepting new patients |
Locations
99 Hawley Ln
Ste 1102
Stratford, CT 06614
1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435
101 Main St
Neenah, WI 54956
Phone (920) 727-4200
2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 68772 | WI | Yes |
Addresses
Primary practice location
101 Main St
Neenah, WI 54956
Mailing address
101 Main St
Neenah, WI 54956-2570
Phone (920) 720-1463
Other practice location 1
1415 Woodland Ave
140
Des Moines, IA 50309-3203
Phone (515) 241-5995
Other practice location 2
1415 Woodland Ave
140
Des Moines, IA 50309-3203
Phone (515) 241-5995
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100080233 | Medicaid | WI |
Other names
- Kelsey Marko
Other providers in Neenah, WI
- Jenna Kemink
- Bethany Kay Kempfert
- Marley L. Kercher
- Jennifer Marie Ketterhagen
- John A Kidd
- Kind Prevention LLC
- Kindred Health Care
- Kindred Healthcare
- Kindred Healthcare
- Brittney King
All providers in Neenah, WI · Internal Medicine 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 21, 2024. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.