NPIMap

Individual provider Active NPI

Kyle Dembowiak, MD

  • Family Medicine Physician
  • Antigo, WI
National Provider Identifier
1235499815
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62206 Issued in WI
Practice address
112 E 5TH Ave
Antigo, WI 54409-2710
Phone
(715) 623-2331
NPI assigned
May 17, 2012
Last updated
Jul 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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 62206 WI Primary

Addresses

Primary practice location

112 E 5TH Ave
Antigo, WI 54409-2710

Mailing address

112 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150805006698 WI Practitioner - Family Practice 7517271539 Reassigns benefits to 6 organizations
I20230330000439 MI Practitioner - Family Practice 7517271539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Langlade Hospital - Hotel Dieu of St Joseph of Antigo WisconsinGroup PAC ID 1557271202, shared by 7 NPIs, 86 clinicians

Practice addresses (Care Compare)

110 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2351

112 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2331

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.2 of 100Reported as group
Quality
84.08
Promoting interoperability
100
Improvement activities
40
Cost
64.31

Merit-based Incentive Payment System (MIPS)

Final score
90.56 of 100Reported as group
Quality
87.43
Promoting interoperability
100
Improvement activities
40
Cost
78.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62206WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital, Inc. CurrentSince Jul 7, 2015 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Family Medicine Current Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Jun 5, 2018 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Jun 5, 2018 Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin CurrentSince Jul 7, 2015 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Jul 7, 2015 Accepting new patients
Aspirus Wausau Hospital Inc CurrentSince Jul 7, 2015 Accepting new patients
3D Healthcare Consulting LLC CurrentSince Dec 1, 2025 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Family Medicine Current Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

729 Park St
Antigo, WI 54409
Phone (715) 362-5583

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

2720 Plaza Dr
Ste 1100
Wausau, WI 54401
Phone (715) 847-2472

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

425 Wind Ridge Dr
Wausau, WI 54401
Phone (715) 675-3391

Interoperability endpoints

  • Direct secure messaging: kdembowiak56599@direct.aspirus.org

Organizations & group practices 11

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 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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1235499815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMBOWIAK",
        "first_name": "KYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "62206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antigo, WI

Sources for this page

Verify at the official NPI Registry.