NPIMap

Organization Active NPI

Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Menomonie, WI
National Provider Identifier
1427008986
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
1990 Issued in WI
Legal business name
MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC.
Practice address
407 21St St SE
Menomonie, WI 54751-2217
Phone
(715) 838-5270
NPI assigned
May 12, 2006
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Adam Smith
Title
Cfo
Phone
(715) 838-5275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 1990 WI Primary

Addresses

Primary practice location

407 21St St SE
Menomonie, WI 54751-2217

Mailing address

1221 Whipple St
Eau Claire, WI 54703-5270
Phone (715) 838-5270

Other identifiers 2

IdentifierTypeStateIssuer
11011800MedicaidWI
42064000MedicaidWI

Other names 1

  • MAYO CLINIC DIALYSIS-MENOMONIE Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060427000799 WI Part A Provider - End-Stage Renal Disease Facility (ESRD) 4385553627 Practice locations: Menomonie, WI

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Mayo Clinic Dialysis - MenomonieCCN 522331
Overall star rating
3.0 of 5
Ownership
Non-profit
Certified
Oct 6, 1999
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Mayo Clinic Dialysis
Dialysis stations
24

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1092944Mayo Clinic Health System Dialysis Menomonie407 21St St, Menomonie, WI 54751Certificate of waiverDec 7, 2026

National Provider Directory

National Provider Directory
Tax ID family
Mayo Clinic HLTH Sys NW Wi25 organizations share this tax ID, including this one
Part of
Mayo Clinic HLTH Sys NW Wi

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Mayo Clinic
    • Durable Medical Equipment & Medical Supplies
    • Rochester, MN
    • NPI 1467622092

    Member Of

    NPD member

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1427008986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 WHIPPLE ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035270",
            "telephone_number": "715-838-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 21ST ST SE",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512217",
            "telephone_number": "715-838-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC HEALTH SYSTEM-NORTHWEST WISCONSIN REGION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-838-5275"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "WI",
            "license": "1990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11011800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42064000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MAYO CLINIC DIALYSIS-MENOMONIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Menomonie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.