Alicia-Maria Fernandez, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

50947 Issued in WI

Practice address

402 W Lake St
Friendship, WI 53934-9699

Phone

(608) 339-3331

NPI assigned

Oct 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mile Bluff Medical Center IncGroup PAC ID 8527971399, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mile Bluff Medical Center Hospital, Mauston, WI, CCN 520109

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mile Bluff Medical Center Inc

  • Emergency Medicine Physician
  • Mauston, WI
  • NPI 1609912005
  Medicare reassignment Care Compare group NPD
• Moundview Memorial Hospital & Clinics, Inc

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533

  Internal Medicine

  Medicare reassignment NPD
• Primary Connection Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wausau, WI
  • NPI 1457370744

  Pediatrics

  Medicare reassignment NPD
• Mile Bluff Medical Center Inc

  • Urgent Care Clinic/Center
  • Mauston, WI
  • NPI 1437958683
  NPD
• Mile Bluff Medical Center Inc

  • Rural Health Clinic/Center
  • Wisconsin Dells, WI
  • NPI 1487734380
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  • Clinic Pharmacy
  • Friendship, WI
  • NPI 1669056693
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Westfield, WI
  • NPI 1861829194
  NPD
• Advanced Healthcare SC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1154371847
  NPD (past)
• Mile Bluff Medical Center Inc

  • Rural Health Clinic/Center
  • Elroy, WI
  • NPI 1285770016
  NPD (past)
• Mile Bluff Medical Center Inc

  • Rural Health Clinic/Center
  • Necedah, WI
  • NPI 1447397492
  NPD (past)
• Mile Bluff Medical Center Inc

  • General Acute Care Hospital
  • Mauston, WI
  • NPI 1568487411
  NPD (past)
• Mile Bluff Medical Center Inc

  • Rural Health Clinic/Center
  • Mauston, WI
  • NPI 1881930527
  NPD (past)

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

• Mile Bluff Medical Center Inc

  • Urgent Care Clinic/Center
  • Mauston, WI
  • NPI 1437958683

  Hospital

  Care Compare affiliation
• Mile Bluff Medical Center Inc

  • General Acute Care Hospital
  • Mauston, WI
  • NPI 1568487411
  Care Compare affiliation

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407043458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W LAKE ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349699",
            "telephone_number": "608-339-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W LAKE ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349699",
            "telephone_number": "608-339-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 N Martin Luther King Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532122709",
            "country_code": "US",
            "telephone_number": "414-267-4040",
            "fax_number": "414-372-0793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "ALICIA-MARIA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "50947",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "50947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "K400386662",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43545200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Donnelly
• Barbara A Drolson, RN
• Kaye Marie Eckert, PSY.D.
• Scott Alan Ethun, LCSW
• Mary L. Fendt, PT
• Arthur Thomas Foster Sr., LMFT, SACIT
• Kari A. Gatterman, PT
• Gene P. Wegner, SC
• Heidi Golden, LPC-IT, CSAC-IT
• Meagan Lynn Grabarski, MPSW

• Internal Medicine Physician in Friendship, WI
• Providers in Friendship, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• 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.