Ram Rizal

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6569-15 Issued in WI

Practice address

880 Herriott Drive
Mauston, WI 53948

Phone

(920) 787-5514

Fax

(920) 787-4737

NPI assigned

Jul 22, 2010

Last updated

Jul 22, 2010By 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

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ho Chunk Nation

  dba HO CHUNK NATION d/b/a House of Wellness

  • Federally Qualified Health Center (FQHC)
  • Baraboo, WI
  • NPI 1316002694
  NPD (past)
• La Clinica de Los Campesinos, Inc

  • Pharmacy
  • Wautoma, WI
  • NPI 1174322846
  NPD (past)
• La Clinica de Los Campesinos, Inc

  dba Noble Community Clinics

  • Federally Qualified Health Center (FQHC)
  • Stevens Point, WI
  • NPI 1790786929
  NPD (past)

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1265745962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1440",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549821440",
            "telephone_number": "920-787-5514",
            "fax_number": "920-787-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 HERRIOTT DRIVE",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "53948",
            "telephone_number": "920-787-5514",
            "fax_number": "920-787-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZAL",
        "first_name": "RAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6569-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Reinke, SW
• Christine Ferchoff Renner, O.D.
• Rhythm of Life LLC (Whole Life Chiropractic and Wellness Center)
• Dana Deann Rick, RN
• Robert R Riedle, M.D.
• Erika J Roberts, BS
• Marlene Ann Rosenberg, P.T.
• David L Rung, MS COMMUNITY COUNSEL
• Nicole Saad, PT
• Kimberley E. Sabey, D.O.

• General Practice Dentistry in Mauston, WI
• Providers in Mauston, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.