NPIMap

Individual provider Active NPI

Randy J Krszjzaniek, MD

  • Family Medicine Physician
  • Baraboo, WI
National Provider Identifier
1194781229
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32853-020 Issued in WI
Practice address
1700 Tuttle St
Baraboo, WI 53913-3319
Phone
(608) 355-3800
Fax
(608) 355-7001
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32853-020 WI Primary

Addresses

Primary practice location

1700 Tuttle St
Baraboo, WI 53913-3319

Mailing address

1700 Tuttle St
Baraboo, WI 53913-3319
Phone (608) 355-3800

Other identifiers 1

IdentifierTypeStateIssuer
1194781229MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rkrszjzaniek261153@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051222000357 WI Practitioner - Family Practice 9436171170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

1700 Tuttle St
Baraboo, WI 53913-3319
Phone (608) 355-3800

Hospital & facility affiliations

  • SSM Health at Home Home Health-Wisconsin Home health agency, Madison, WI, CCN 527184
  • Aveanna Home Health Home health agency, Baraboo, WI, CCN 527332
  • Agrace Hospicecare Hospice, Madison, WI, CCN 521505
  • SSM Health at Home Hospice Hospice, Baraboo, WI, CCN 521522
  • Bristol Hospice Madison Hospice, Madison, WI, CCN 521613
  • SSM Health St Clare Hospital - Baraboo Hospital, Baraboo, WI, CCN 520057
  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
  • Reedsburg Area Medical Center Hospital, Reedsburg, WI, CCN 521351
  • Sauk Prairie Hospital Hospital, Prairie Du Sac, WI, CCN 520095
  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098
  • Complete Care at Jefferson Meadows LLC Nursing home, Baraboo, WI, CCN 525317
  • Maplewood of Sauk Prairie Nursing home, Sauk City, WI, CCN 525462
  • Sauk Co Health Care Center Nursing home, Reedsburg, WI, CCN 525114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions44
Removal or shaving of skin growth23
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32853-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Nov 1, 2014 Accepting new patients
Dean Health Systems, Inc Family Medicine CurrentSince Nov 1, 2014 Accepting new patients

Locations

1700 Tuttle St
Baraboo, WI 53913
Phone (608) 355-3800

825 Western Ave
Columbus, WI 53925
Phone (920) 623-2520

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Organizations & group practices 2

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1194781229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TUTTLE ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539133319",
            "telephone_number": "608-355-3800",
            "fax_number": "608-355-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TUTTLE ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539133319",
            "telephone_number": "608-355-3800",
            "fax_number": "608-355-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRSZJZANIEK",
        "first_name": "RANDY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "32853-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194781229",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkrszjzaniek261153@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rkrszjzaniek261153@direct-ehr-ssmhc.com",
            "address_1": "1700 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539133319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1700 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539133319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.