Individual provider Active NPI

Elizabeth Wood, MD

  • Family Medicine Physician
  • Portage, WI
National Provider Identifier
1396128930
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71300-20 Issued in WI
Practice address
2817 New Pinery Rd
Portage, WI 53901-9240
Phone
(608) 742-4131
NPI assigned
Jul 1, 2015
Last updated
Jul 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 71300-20 WI Primary

Addresses

Primary practice location

2817 New Pinery Rd
Portage, WI 53901-9240

Mailing address

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

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
I20190801001953 WI Practitioner - Family Practice 2769799881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Divine Savior Healthcare IncGroup PAC ID 5799684007, 135 clinicians

Practice addresses (Care Compare)

2817 New Pinery Rd
Portage, WI 53901-9240
Phone (608) 742-4131

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.7 of 100Reported as group
Quality
91.14
Promoting interoperability
100
Improvement activities
40
Cost
77.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71300-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Divine Savior Healthcare, Inc. Family Medicine CurrentSince Jul 29, 2019 Accepting new patients
Divine Savior Healthcare, Inc. CurrentSince Jul 29, 2019 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598

Interoperability endpoints

  • Direct secure messaging: ewood157117@direct.aspirus.org

Organizations & group practices 2

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 3

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": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1396128930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019240",
            "telephone_number": "608-742-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "71300-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, WI

Sources for this page

Verify at the official NPI Registry.