Mark W Niedfeldt, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35201 Issued in WI

Practice address

10325 N Port Washington Rd Ste 150
Mequon, WI 53092-5768

Phone

(262) 643-4720

Fax

(262) 643-4721

NPI assigned

May 12, 2006

Last updated

Sep 24, 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 1

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

Medical College of Wisconsin, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colab Physicians, SCGroup PAC ID 1052853561, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.niedfeldt.1@18732.direct.athenahealth.com
• Direct secure messaging: mark.niedfeldt@101378185428996.direct.elationemr.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.

• Colab Physicians, SC

  • Family Medicine Physician
  • Mequon, WI
  • NPI 1902666035
  Medicare reassignment Care Compare group NPD Authorized official
• Mark W Niedfeldt, MD, LLC

  • Family Medicine Physician
  • Mequon, WI
  • NPI 1174764906
  NPD (past) Authorized official

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

• Froedtert Memorial Lutheran Hospital, Inc.

  dba CDI-Froedtert Memorial Lutheran Hospital

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255334173
  Care Compare affiliation

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1205887775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10556 NORTH PORT WASHINGTON ROAD",
            "address_2": "SUITE 101",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925586",
            "telephone_number": "262-643-4720",
            "fax_number": "262-643-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10325 N PORT WASHINGTON RD STE 150",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925768",
            "telephone_number": "262-643-4720",
            "fax_number": "262-643-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDFELDT",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "35201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32113600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000187C",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Newcastle Senior Care, LLC (The Highlands at Newcastle Place)
• Jesse L Newell Jr., ATC, LAT
• Newport Professionals LTD
• Newporte Courte Family Chiropractic, LLC
• Julie Senecal Nickerson, MPT
• Lauren Nikolai
• Imaria N Noel
• Susan Nolte, LMFT
• Rebecca Nora, APNP
• Jessica Norgel

• Family Medicine Physician in Mequon, WI
• Providers in Mequon, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.
• 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.