Individual provider Active NPI

Brian H Bielicki

  • Certified Registered Nurse Anesthetist
  • Mauston, WI
National Provider Identifier
1154576569
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
8989-33 Issued in WI
Practice address
1050 Division St
Mauston, WI 53948-1931
Phone
(088) 476-1616
NPI assigned
Nov 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 68193 NE
Certified Registered Nurse Anesthetist 367500000X 901711 NE
Certified Registered Nurse Anesthetist 367500000X 8989-33 WI Primary

Addresses

Primary practice location

1050 Division St
Mauston, WI 53948-1931

Mailing address

1050 Division St
Mauston, WI 53948-1931
Phone (088) 476-1616

Other practice location 1

601 W Leota St
North Platte, NE 69101-6525
Phone (308) 696-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170411002228 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981769262 Reassigns benefits to 3 organizations
I20190319001305 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981769262 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mile Bluff Medical Center IncGroup PAC ID 8527971399, 87 clinicians
Cumberland Memorial Hospital IncGroup PAC ID 7719889203, 19 clinicians

Practice addresses (Care Compare)

1040 Division St
Mauston, WI 53948-1931
Phone (608) 847-1852

1050 Division St
Mauston, WI 53948-1931

1705 16TH Ave
Cumberland, WI 54829-8601
Phone (715) 822-7222

28 Commerce St
Wisconsin Dells, WI 53965-8293
Phone (608) 254-8888

Hospital & facility affiliations

  • Mile Bluff Medical Center Hospital, Mauston, WI, CCN 520109
  • Cumberland Memorial Hospital Hospital, Cumberland, WI, CCN 521353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
68193NEMDRegistered Nurse
901711NEMDCertified Registered Nurse Anesthetist
8989-33WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mile Bluff Medical Center Inc Current Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Dec 1, 2021 Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Dec 1, 2021 Accepting new patients
Mile Bluff Medical Center Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2021 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Mar 22, 2017 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Sandusky Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 30, 2018 Accepting new patients
Midwest Anesthesia Care, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Mar 1, 2019 Accepting new patients
Mile Bluff Medical Center Inc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 10th St E
Waconia, MN 55387

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

15028 State Route 224 E
Findlay, OH 45840
Phone (419) 427-3040

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

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

1050 Division St
Mauston, WI 53948
Phone (608) 847-6161

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

2200 Cedar Crest Dr
Ste B
Rice Lake, WI 54868
Phone (586) 864-6006

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

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 3

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": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1154576569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "088-476-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "088-476-1616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W Leota St",
            "address_purpose": "LOCATION",
            "city": "North Platte",
            "state": "NE",
            "postal_code": "691016525",
            "country_code": "US",
            "telephone_number": "308-696-8000",
            "fax_number": "308-696-8349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIELICKI",
        "first_name": "BRIAN",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-26",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "68193",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "901711",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "8989-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauston, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.