Daniel G. Derezinski, MS RADCI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

13414 Issued in WI

Practice address

2450 Vineyard Dr
Plover, WI 54467-3973

Phone

(715) 342-0290

NPI assigned

Sep 16, 2006

Last updated

Feb 14, 2024By the provider in NPPES

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

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.

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  dba Marshfield Medical Center

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• MCHS Hospitals Inc

  dba MCHS Hospitals Inc Outreach Services

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  • NPI 1427642255
  NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Eau Claire Cancer Center

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• MCHS Hospitals Inc

  dba Marshfield Medical Center - Ladysmith

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• Memorial Hospital Inc

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1174629927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511",
            "fax_number": "715-344-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 VINEYARD DR",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544673973",
            "telephone_number": "715-342-0290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "209 Prentice St N",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544811162",
            "country_code": "US",
            "telephone_number": "715-343-3354",
            "fax_number": "715-344-8127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEREZINSKI",
        "first_name": "DANIEL",
        "middle_name": "G.",
        "credential": "MS RADCI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "13414",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "3804",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADC I",
            "identifier": "13414",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "2450 Vineyard Dr",
            "city": "Plover",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544673973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Compassus Aah of Wisconsin IV, LLC (Compassus - Wausau)
• Cornerstone Clinic LLC
• Genesis Anne Cratsenberg
• Clare A Cullen, APNP
• Joshua Alan Deisinger, LPC, SAC-IT
• Christopher Thomas Deroche, DPM
• Sara R Ebel, A.T.,C
• Mark S Ensweiler, DC LAC
• Mark F Fenlon, MD
• Heidi Renee Filko, MSW, APSW

• Addiction (Substance Use Disorder) Counselor in Plover, WI
• Providers in Plover, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.