Don L Custodio, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

3088 Issued in WI

Practice address

4100 State Highway 66
Stevens Point, WI 54482-8410

Phone

(715) 343-7700

NPI assigned

May 11, 2007

Last updated

Feb 19, 2024By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, AZ, TN, WI4 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 4

Specialty

Emergency Medicine

Education

Michigan State University College of Human Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist North Emergency Physicians, PLLCGroup PAC ID 0941659247, 43 clinicians

Germantown Emergency Physicians, PLLCGroup PAC ID 7214386812, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dcustodio24979@mlh.direct-ci.com
• Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

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.

• Germantown Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Germantown, TN
  • NPI 1518747526
  Medicare reassignment Care Compare group NPD
• Methodist North Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Memphis, TN
  • NPI 1801677083
  Medicare reassignment Care Compare group NPD
• Beaver Dam Community Hospitals Inc

  dba Marshfield Medical Center - Beaver Dam Professional Services

  • Clinic/Center
  • Beaver Dam, WI
  • NPI 1972188555
  Medicare reassignment NPD
• Flambeau Hospital Inc

  dba MMC - Park Falls Outreach Services

  • Clinic/Center
  • Park Falls, WI
  • NPI 1194317966
  Medicare reassignment NPD
• Flambeau Hospital Inc

  dba Marshfield Medical Center - Park Falls

  • Critical Access Hospital
  • Park Falls, WI
  • NPI 1700963048
  Medicare reassignment NPD
• Lakeview Medical Center Inc of Rice Lake

  dba Marshfield Medical Center - Rice Lake Professional Services

  • Clinic/Center
  • Rice Lake, WI
  • NPI 1093201832
  Medicare reassignment NPD
• Marshfield Clinic Inc

  dba Marshfield Clinic Florida Teleradiology/Telehealth

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434

  Emergency Medicine

  Medicare reassignment NPD
• MCHS Hospitals Inc

  dba Marshfield Medical Center - Ladysmith

  • Critical Access Hospital
  • Ladysmith, WI
  • NPI 1952890873
  Medicare reassignment NPD
• Memorial Hospital Inc

  dba Marshfield Medical Center - Neillsville

  • Critical Access Hospital
  • Neillsville, WI
  • NPI 1346239373
  Medicare reassignment NPD
• Baraga County Memorial Hospital

  • Critical Access Hospital
  • L'Anse, MI
  • NPI 1558479824
  Medicare reassignment NPD
• Baraga County Memorial Hospital

  dba BCMH Physician Group

  • Family Medicine Physician
  • L'Anse, MI
  • NPI 1851409643
  Medicare reassignment NPD

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

• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1558365890
  Care Compare affiliation
• Methodist Healthcare - Memphis Hospitals

  dba Le Bonheur Children's Hospital - Germantown

  • Children's Hospital
  • Germantown, TN
  • NPI 1649654450
  Care Compare affiliation

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1316152598",
    "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": "4100 STATE HIGHWAY 66",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544828410",
            "telephone_number": "715-343-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3232 Coolidge Hwy",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736854",
            "country_code": "US",
            "telephone_number": "810-845-4593",
            "fax_number": "248-551-5426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUSTODIO",
        "first_name": "DON",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301085609",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "3088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "4100 State Highway 66",
            "city": "Stevens Point",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544828410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Earl Crow, D.D.S.
• Jon-Ross Crow, D.D.S.
• Sarah Crow, DPT
• Leia Cruz-Perez, RN
• Gary Dean Cumley, SPEECH-LANGUAGE PATH
• Douglas J Cybela, PHD
• Kay Lynn Czerwinski, APNP
• Danielle Dahl
• Daily Dental LLC
• Amber Damrau, APRN, FNP

• Emergency Medicine Physician in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.