NPIMap

Individual provider Active NPI

Edward James Mauch, D.O.

  • Family Medicine Physician
  • Amery, WI
National Provider Identifier
1407082639
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
57240 Issued in WI
Practice address
265 Griffin St E
Amery, WI 54001
Phone
(715) 268-8000
NPI assigned
Jun 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 53097 MN
Family Medicine Physician 207Q00000X 57240 WI Primary

Addresses

Primary practice location

265 Griffin St E
Amery, WI 54001

Mailing address

2600 65TH Ave
Osceola, WI 54020-4370
Phone (715) 294-5766

Other identifiers 4

IdentifierTypeStateIssuer
1407082639MedicaidMN
1407082639OtherBCBS
P00860779OtherRAILROAD MEDICARE
01-42339OtherMEDICA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100914000197 MN Practitioner - HospitalistPractitioner - Family Practice 9739204868 Reassigns benefits to 1 organization
I20120905000145 WI Practitioner - HospitalistPractitioner - Family Practice 9739204868 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amery Regional Medical Center IncGroup PAC ID 2769391960, 124 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

927 Churchill W St
Stillwater, MN 55082-6605
Phone (651) 439-5330

Hospital & facility affiliations

  • Amery Hospital & Clinic Hospital, Amery, WI, CCN 521308
  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Amery Hospital & Clinic Nursing home, CCN 52Z308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57240WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2018 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 31, 2025 Accepting new patients
Group Health Plan, Inc. CurrentSince Jul 1, 2018 Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2018 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Lakeview Memorial Hospital Association Inc Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Organizations & group practices 9

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1407082639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 65TH AVE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540204370",
            "telephone_number": "715-294-5766",
            "fax_number": "715-294-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 GRIFFIN ST E",
            "city": "AMERY",
            "state": "WI",
            "postal_code": "54001",
            "telephone_number": "715-268-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUCH",
        "first_name": "EDWARD",
        "middle_name": "JAMES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "53097",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "57240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407082639",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1407082639",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00860779",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "01-42339",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amery, WI

Sources for this page

Verify at the official NPI Registry.