Karen S Ailsworth, MD

Individual provider Active NPI Pediatrics Physician · Baraboo, WI

NPI 1467418335 · NPPES record last updated Feb 1, 2022

Key facts

NPI
1467418335
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
35472-020 (WI)
Practice address
1700 Tuttle St
Baraboo, WI 53913-3319
Phone
(608) 355-3800
Fax
(608) 355-7001
NPI assigned
Apr 21, 2006
Sex
Female
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 participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35472-020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc, Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35472-020 WI Yes

Addresses

Primary practice location

1700 Tuttle St
Baraboo, WI 53913-3319

Mailing address

1515 Ash St
Baraboo, WI 53913-1356
Phone (608) 355-1240

Other identifiers

IdentifierTypeStateIssuer
32039800MedicaidWI
1000147OtherWIPHYSICIANS PLUS
4275OtherWIDEAN HEALTH INSURANCE

Other providers in Baraboo, WI

All providers in Baraboo, WI · Pediatrics Physician in Wisconsin

Sources for this page

Verify at the official NPI Registry.