Individual provider Active NPI

Carl Henry Zondlo

  • Certified Registered Nurse Anesthetist
  • Medford, WI
National Provider Identifier
1215549852
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA Issued in WI
Practice address
135 S Gibson St
Medford, WI 54451-1622
Phone
(715) 748-8100
NPI assigned
Aug 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA WI Primary

Addresses

Primary practice location

135 S Gibson St
Medford, WI 54451-1622

Mailing address

N3445 Woodland Rd
Medford, WI 54451-8654
Phone (715) 965-3694

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210203001663 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052725066 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Medford Hospital and Clinics IncGroup PAC ID 5799688602, shared by 9 NPIs, 126 clinicians

Practice addresses (Care Compare)

135 S Gibson St
Medford, WI 54451-1622
Phone (715) 748-8100

Hospital & facility affiliations

  • Aspirus Medford Hospital & Clinics, Inc Hospital, Medford, WI, CCN 521324

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.16
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Dec 30, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 4, 2021 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Dec 30, 2022 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince Jan 4, 2021 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
MCHS Hospitals Inc CurrentSince Jan 4, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

2310 Craig Rd
Eau Claire, WI 54701
Phone (715) 858-4500

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/67ff075a-8289-4f2d-a8eb-5dc1f0d954ab/

Organizations & group practices 7

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1215549852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3445 WOODLAND RD",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544518654",
            "telephone_number": "715-965-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZONDLO",
        "first_name": "CARL",
        "middle_name": "HENRY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "NA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.