Active NPI
David P Dielentheis, MD
- Obstetrics & Gynecology Physician
- Sheboygan, WI
National Provider Identifier
1447304423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 26953
- Practice address
- 2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129 - Phone
- (920) 457-4461
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 26953 | WI | Primary |
Addresses
Primary practice location
2414 Kohler Memorial Dr
Sheboygan, WI 53081-3129
Mailing address
5015 Blackstock Rd
Sheboygan, WI 53083-2206
Phone (920) 452-0729
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31397900 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ddielentheis45056@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- ddielentheis45056@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1447304423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5015 BLACKSTOCK RD",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530832206",
"telephone_number": "920-452-0729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2414 KOHLER MEMORIAL DR",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813129",
"telephone_number": "920-457-4461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIELENTHEIS",
"first_name": "DAVID",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WI",
"license": "26953",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31397900",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ddielentheis45056@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2414 Kohler Memorial Dr",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530813129",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2414 Kohler Memorial Dr",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530813129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.