Individual provider Active NPI

Brian Menkhaus, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Sheridan, WY
National Provider Identifier
1447516240
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
10472A Issued in WY
Practice address
1401 W 5TH St
Sheridan, WY 82801-2705
Phone
(307) 672-1041
Fax
(307) 675-2603
NPI assigned
Apr 5, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Pathology
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Pathology Associates PC (2 clinicians)

Practice addresses (Care Compare)

1401 W 5TH St
Sheridan, WY 82801-2705
Phone (307) 672-1040

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161018002706 WY Practitioner - Pathology 7315235710 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Pathology Associates PC Anatomic Pathology & Clinical Pathology Current
since Aug 28, 2016
Accepting new patients

Locations

1401 W 5th St
Sheridan, WY 82801
Phone (307) 672-1000

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 10472A WY Primary

Addresses

NPPES NPI Registry

Primary practice location

1401 W 5TH St
Sheridan, WY 82801-2705

Mailing address

1401 W 5TH St
Sheridan, WY 82801-2705
Phone (307) 672-1041

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 23, 2016.

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1447516240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W 5TH ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012705",
            "telephone_number": "307-672-1041",
            "fax_number": "307-675-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W 5TH ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012705",
            "telephone_number": "307-672-1041",
            "fax_number": "307-675-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENKHAUS",
        "first_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WY",
            "license": "10472A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.