Iris Theodora Cinco Perez-Marquardt, M.D
Individual provider Active NPI Family Medicine Physician · Oconto Falls, WI
NPI 1306825872 · NPPES record last updated Nov 18, 2022
Key facts
- NPI
- 1306825872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 38426-020 (WI)
- Practice address
- 107 E Highland Dr
Oconto Falls, WI 54154-1002 - Phone
- (920) 846-3092
- Fax
- (920) 846-8313
- NPI assigned
- Jan 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bellin Memorial Hospital Inc
Oconto Hospital and Medical Center Inc
Practice addresses (Care Compare)
100 E Highland Dr
Oconto Falls, WI 54154-1001
Phone (920) 846-3272
107 E Highland Dr
Oconto Falls, WI 54154-1002
Phone (920) 846-3092
Hospital & facility affiliations
- Unity Hospice
- Bellin Health Oconto Hospital
- Bellin Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100809000131 | WI | Practitioner - Family Practice | 7810020021 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38426-020 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oconto Hospital & Medical Center Inc | Family Medicine | Current |
Accepting new patients |
| Bellin Memorial Hospital Inc | Family Medicine | Current |
Accepting new patients |
| Oconto Hospital & Medical Center Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Family Medicine | Current | Accepting new patients |
| Oconto Hospital & Medical Center, Inc. | Family Medicine | Current |
Accepting new patients |
| Bellin Memorial Hospital Inc | Family Medicine | Current |
Accepting new patients |
| St Clare Memorial Hospital, Inc | Past | Accepting new patients |
Locations
401 W Mill St
Bonduel, WI 54107
Phone (715) 758-2167
218 S US Highway 141
Crivitz, WI 54114
Phone (715) 854-7477
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
833 S Main St
Oconto Falls, WI 54154
Phone (920) 338-6866
100 E Highland Dr
Oconto Falls, WI 54154
Phone (920) 848-3272
107 E Highland Dr
Oconto Falls, WI 54154
Phone (920) 846-0509
855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187
441 French St
Peshtigo, WI 54157
Phone (715) 582-3622
607 E Bronson Rd
Seymour, WI 54165
Phone (920) 833-6856
Interoperability endpoints
- iperez175253@direct.thedacare.org
- iperezmarquardt924957@direct.emplifyhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 38426-020 | WI | Yes |
Addresses
Primary practice location
107 E Highland Dr
Oconto Falls, WI 54154-1002
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100
Other practice location 2
401 W Mill St
Bonduel, WI 54107-9246
Phone (715) 758-2167
Other practice location 3
441 French St
Peshtigo, WI 54157-1203
Phone (715) 582-9949
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32348900 | Medicaid | WI |
Other names
- Iris Theodora Cinco Perez
Other providers in Oconto Falls, WI
- Jessica Otten
- Jeff Thomas Pagel
- Kari Pagel
- Pain Centers of Wisconsin - Oconto Falls, LLC
- Pain Centers of Wisconsin - Oconto Falls, LLC
- Gavin Paul Peters
- June Marie Peters
- Gregory A Peyer
- Shari L Pfankuch
- Ella Preston
All providers in Oconto Falls, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.