Individual provider Active NPI

Darrin Antonelli, M.D.

  • Surgery Physician
  • Black River Falls, WI
National Provider Identifier
1386673481
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
42121 Issued in WI
Practice address
610 W Adams St
Black River Falls, WI 54615-9010
Phone
(715) 284-4311
Fax
(715) 284-2568
NPI assigned
Jul 1, 2006
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 42121 WI Primary

Addresses

Primary practice location

610 W Adams St
Black River Falls, WI 54615-9010

Mailing address

610 W Adams St
Black River Falls, WI 54615-9010
Phone (715) 284-4311

Other practice location 1

711 W Adams St
Black River Falls, WI 54615-5052
Phone (715) 284-5361

Other identifiers 1

IdentifierTypeStateIssuer
32648400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100109000019 WI Practitioner - General SurgeryPractitioner - Hospice/Palliative Care 9234030685 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Hospice/Palliative Care
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black River Health IncGroup PAC ID 3173431178, 62 clinicians

Practice addresses (Care Compare)

711 W Adams St
Black River Falls, WI 54615-5052
Phone (715) 284-5361

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.18 of 100Reported as group
Quality
87.29
Promoting interoperability
100
Improvement activities
40
Cost
65.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Black River Health Inc CurrentSince Dec 30, 2024 Accepting new patients
Krohn Clinic LTD. CurrentSince Sep 1, 2000 Accepting new patients
Black River Health Inc CurrentSince Dec 30, 2024 Accepting new patients

Locations

610 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-4311

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-3604

Interoperability endpoints

  • Direct secure messaging: darrin.antonelli@kcld.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BHJBDA

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1386673481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159010",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159010",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-2568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 W Adams St",
            "address_purpose": "LOCATION",
            "city": "Black River Falls",
            "state": "WI",
            "postal_code": "546155052",
            "country_code": "US",
            "telephone_number": "715-284-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTONELLI",
        "first_name": "DARRIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "42121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32648400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Black River Falls, WI

Sources for this page

Verify at the official NPI Registry.