NPIMap

Individual provider Active NPI

Madeleine Neri Guevara, D.O.

  • Obstetrics Physician
  • De Pere, WI
National Provider Identifier
1225254451
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
70883-21 Issued in WI
Practice address
1716 Lawrence Dr Ste 100
De Pere, WI 54115-9108
Phone
(920) 605-3115
Fax
(920) 486-6826
NPI assigned
Apr 17, 2007
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101016138 MI
Obstetrics Physician 207VX0000X 70883-21 WI Primary

Addresses

Primary practice location

1716 Lawrence Dr Ste 100
De Pere, WI 54115-9108

Mailing address

1716 Lawrence Dr
De Pere, WI 54115-9108
Phone (920) 605-3115

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
I20190607000084 WI Practitioner - Obstetrics/Gynecology 5496818890 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Gianna Molla Clinic, IncGroup PAC ID 2163836339, 5 clinicians

Practice addresses (Care Compare)

1716 Lawrence Dr
Suite 100
De Pere, WI 54115-9108
Phone (920) 605-3115

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
77.62
Promoting interoperability
100
Improvement activities
40
Cost
78.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016138MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Gianna Molla Clinic, Inc Obstetrics & Gynecology CurrentSince Jan 1, 2021 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 23, 2023 Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Oct 23, 2023 Accepting new patients
Aspirus Wausau Hospital Inc CurrentSince Oct 23, 2023 Accepting new patients
Aspirus Medical Group, Inc. Current Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Medical Group, Inc. Obstetrics & Gynecology CurrentSince Oct 23, 2023 Accepting new patients
Ear Nose & Throat Surgical Associates SC PastSince Jan 1, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1716 Lawrence Dr
De Pere, WI 54115
Phone (920) 605-3115

1716 Lawrence Dr
#100
De Pere, WI 54115
Phone (920) 605-3115

2720 Plaza Dr
Ste 1400
Wausau, WI 54401
Phone (715) 847-2004

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Interoperability endpoints

  • Direct secure messaging: madeleine.guevara.1@25400.direct.athenahealth.com

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1225254451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108",
            "telephone_number": "920-605-3115",
            "fax_number": "920-486-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 LAWRENCE DR STE 100",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108",
            "telephone_number": "920-605-3115",
            "fax_number": "920-486-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "MADELEINE",
        "middle_name": "NERI",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-06-12",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101016138",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WI",
            "license": "70883-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.