NPIMap

Individual provider Active NPI

Deno N. Karegeannes, PA-C

  • Physician Assistant
  • Minocqua, WI
National Provider Identifier
1295721041
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2316 Issued in WI
Practice address
9601 Townline Rd
Minocqua, WI 54548-9099
Phone
(715) 358-1000
Fax
(715) 358-1156
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2316 WI Primary

Addresses

Primary practice location

9601 Townline Rd
Minocqua, WI 54548-9099

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other identifiers 1

IdentifierTypeStateIssuer
25374826MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20200317000150 CO Practitioner - Physician Assistant 6608875059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Montrose Regional Health Hospital, Montrose, CO, CCN 060006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1504COMDClinical Psychologist
2316WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Feb 28, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Feb 28, 2020 Accepting new patients
Rocky Mountain Orthopaedic Associates PC Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

750 Wellington Ave
Ste 3A
Grand Junction, CO 81501
Phone (970) 248-3188

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

Organizations & group practices 6

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 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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295721041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 TOWNLINE RD",
            "city": "MINOCQUA",
            "state": "WI",
            "postal_code": "545489099",
            "telephone_number": "715-358-1000",
            "fax_number": "715-358-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAREGEANNES",
        "first_name": "DENO",
        "middle_name": "N.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25374826",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minocqua, WI

Sources for this page

Verify at the official NPI Registry.