Individual provider Active NPI

Mary McDaniel, MD

  • Dermatology Physician
  • Oconto, WI
National Provider Identifier
1184015984
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
81655-20 Issued in WI
Practice address
820 Arbutus Ave
Oconto, WI 54153-2004
Phone
(920) 835-1100
NPI assigned
Feb 16, 2015
Last updated
Sep 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 7327 OH
Dermatology Physician 207N00000X 81655-20 WI Primary

Addresses

Primary practice location

820 Arbutus Ave
Oconto, WI 54153-2004

Mailing address

PO Box 23400
Green Bay, WI 54305-3400

Other practice location 1

1400 Scheuring Rd
DE Pere, WI 54115-1067
Phone (920) 964-0229

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Mary.McDaniel@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230830001722 WI Practitioner - Dermatology 6305172123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Northeastern Ohio University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

1400 Scheuring Rd
De Pere, WI 54115-1067
Phone (920) 964-0229

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision90
Removal of skin lesions418
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy239

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7327OHMDRegistered Dietitian
81655-20WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jul 17, 2023 Accepting new patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Jul 17, 2023 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

1400 Scheuring Rd
De Pere, WI 54115
Phone (920) 964-0229

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789603200000",
    "number": "1184015984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23400",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543053400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 ARBUTUS AVE",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541532004",
            "telephone_number": "920-835-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Scheuring Rd",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541151067",
            "country_code": "US",
            "telephone_number": "920-964-0229",
            "fax_number": "920-964-0248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "7327",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "81655-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mary.McDaniel@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "1400 Scheuring Rd",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541151067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oconto, WI

Sources for this page

Verify at the official NPI Registry.