Wendy L Molaska, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

51915-20 Issued in WI

Practice address

2990 Triverton Pike Dr # 101
Fitchburg, WI 53711-5904

Phone

(608) 305-4515

Fax

(608) 721-6006

NPI assigned

Dec 16, 2005

Last updated

Jan 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2021 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Agrace Hospicecare, Incorporated

  • Community Based Hospice Care Agency
  • Fitchburg, WI
  • NPI 1861503534

  Family Medicine

  NPD (past)
• Dean Health Systems, Inc,

  dba Dean Clinic-Beaver Dam Family & Sports Orthopedic Center

  • Durable Medical Equipment & Medical Supplies
  • Beaver Dam, WI
  • NPI 1336425016
  NPD (past)
• Bridge Medical Supply, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Minneapolis, MN
  • NPI 1245504489
  NPD (past)
• University of Minnesota Physicians

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1477598118
  NPD (past)
• University of Minnesota Physicians

  dba Dental Clinic

  • Dental Clinic/Center
  • Minneapolis, MN
  • NPI 1952546061
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1336125939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3034 BOSSHARD DR",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115858",
            "telephone_number": "612-770-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 TRIVERTON PIKE DR # 101",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115904",
            "telephone_number": "608-305-4515",
            "fax_number": "608-721-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLASKA",
        "first_name": "WENDY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "42881",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "51915-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34288500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52103234",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "60752",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Filson Ali Mire
• Mission Respite LLC
• Mo Transit LLC
• Mobilitycare Transport LLC
• Grace Modglin
• Cassandra Montanio
• Moon Transit LLC
• Erin Nicole Moon, LCSW
• Andrew D Moore, MD
• Cynthia R Moore, APSW

• Family Medicine Physician in Fitchburg, WI
• Providers in Fitchburg, 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 Jan 18, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.