Juan Sebastian Preciado-Riestra, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

46438-020 Issued in WI

Practice address

400 S Townline Rd
Wautoma, WI 54982-6922

Phone

(920) 787-4737

NPI assigned

Jun 8, 2005

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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Fairview ClinicsGroup PAC ID 7113830142, shared by 2 NPIs, 799 clinicians

Healtheast Medical Research InstituteGroup PAC ID 3971407636, 665 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
• River Falls Area Hospital Hospital, River Falls, WI, CCN 521349
• M Health Fairview Woodwinds Hospital Hospital, Woodbury, MN, CCN 240213
• M Health Fairview St John'S Hospital Hospital, Maplewood, MN, CCN 240210

Procedures performed for Medicare patients

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

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juanpreciado-riestra@indmectr.allscriptsdirect.net
• Direct secure messaging: jpreciadoriestra916250@fairview.direct-ci.com

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.

• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment Care Compare group NPD
• Fairview Clinics

  • Specialist
  • River Falls, WI
  • NPI 1811550155
  Medicare reassignment NPD
• Indianhead Medical Center Shell Lake, Inc.

  • Primary Care Clinic/Center
  • Siren, WI
  • NPI 1053859058
  Medicare reassignment NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Indianhead Medical Center Shell Lake, Inc

  • Critical Access Hospital
  • Shell Lake, WI
  • NPI 1568438125
  NPD
• Indianhead Medical Center Shell Lake, Inc.

  • Rural Health Clinic/Center
  • Shell Lake, WI
  • NPI 1659899078
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Healtheast Medical Research Institute

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD
• Healtheast Medical Research Institute

  • Family Medicine Physician
  • Woodbury, MN
  • NPI 1588063580
  NPD
• Fairview Clinics

  • Multi-Specialty Clinic/Center
  • Maple Grove, MN
  • NPI 1841315165
  NPD (past)

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

• Allina Health System

  • Orthopaedic Surgery Physician
  • River Falls, WI
  • NPI 1184244519

  Hospital

  Care Compare affiliation
• Allina Health System

  • Critical Access Hospital
  • River Falls, WI
  • NPI 1285691725
  Care Compare affiliation
• Allina Health System

  • Hematology & Oncology Physician
  • River Falls, WI
  • NPI 1568999712

  Hospital

  Care Compare affiliation
• Allina Health System

  • Emergency Medicine Physician
  • River Falls, WI
  • NPI 1578507513

  Hospital

  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1316008212
  Care Compare affiliation
• Fairview Health Services

  • Skilled Nursing Facility
  • Minneapolis, MN
  • NPI 1669459913

  Hospital

  Care Compare affiliation
• Healtheast St. John'S Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  Care Compare affiliation
• Healtheast Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  Care Compare affiliation

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1295739225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BUFFALO RIDGE LN",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549818192",
            "telephone_number": "715-252-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S TOWNLINE RD",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549826922",
            "telephone_number": "920-787-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRECIADO-RIESTRA",
        "first_name": "JUAN",
        "middle_name": "SEBASTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "46438-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART A - CLINIC",
            "identifier": "521823",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34313600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LIC",
            "identifier": "46438",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE A MOBIL UNIT",
            "identifier": "521824",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Peterson, PHARMR
• Keela Marie Phillips, APSW
• Tanya L Pierce, RDH
• William Russell Pinkonsly, M.D.
• Raymond Pratt
• Cheston E Price, M.D.
• Cari L Pronschinske, RN
• RCS Management Corp
• Janet Kriedermann Recore, RDH
• Rianna Reid

• Family Medicine Physician in Wautoma, WI
• Providers in Wautoma, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.
• 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.