Aspirus Medical Group, Inc.
Organization Active NPI Clinic/Center · Marathon, WI
NPI 1164500351 · NPPES record last updated Jun 14, 2024
Key facts
- NPI
- 1164500351
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- ASPIRUS MEDICAL GROUP, INC.
- Practice address
- 670 Community Cir
Marathon, WI 54448-9003 - Phone
- (715) 443-6767
- NPI assigned
- Nov 2, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ASPIRUS CLINICS, INC
Authorized official
- Name
- Jerry M Yang
- Title
- SVP & Chief Financial Officer
- Phone
- (715) 847-2526
Practitioners 16
-
Benjamin S Battino, M.D.
-
Sarah Kathryn Houdek, APNP
-
David J Locknane, PAC
-
Laura E Sherrill, M.D.
-
Alisa Marie Berger, M.D.
-
Charles Tanner Hughes, M.D.
-
Katie A Gilbert, AGACNP-BC
-
Tracy L. Kiener, PT
-
Lori A Schutte, APNP
-
Thomas G Stoffel, MD
-
Thomas Murray Baker, M.D.
-
Jessica Quesenberry Cooke, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031103000267 | WI | Part B Supplier - Clinic/Group Practice | 1052223625 |
Receives reassigned benefits from 484 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Aspirus Clinic Pharmacy
Locations
670 Community Cir
Marathon, WI 54448
Phone (715) 443-6767
2720 Plaza Dr
Ste 1100
Wausau, WI 54401
Phone (715) 847-2472
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | WI | Yes |
Addresses
Primary practice location
670 Community Cir
Marathon, WI 54448-9003
Mailing address
29980 Network PL
Chicago, IL 60673-1299
Phone (715) 847-2304
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21272200 | Medicaid | WI |
Other names
- Aspirus Marathon Clinic
- Aspirus Clinics, Inc.
Other providers in Marathon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.