Karen Ronquillo, M.S., M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

55146-20 Issued in WI

Practice address

20611 Watertown Rd Ste C
Waukesha, WI 53186-1871

Phone

(262) 333-3173

Fax

(262) 333-3173

NPI assigned

Jan 14, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Dr. Karen Dizon Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

State licenses

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467757948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E BROADWAY",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531873001",
            "telephone_number": "414-708-8852",
            "fax_number": "262-364-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20611 WATERTOWN RD STE C",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531861871",
            "telephone_number": "262-333-3173",
            "fax_number": "262-333-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONQUILLO",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "M.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083C0008X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "WI",
            "license": "55146-20",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN 378",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "55146-020",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WI",
            "license": "55146-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ET905Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003237000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "karenronquillo@n-o-v-a.com",
            "affiliation": "N",
            "endpointDescription": "company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20611 Watertown Rd Ste C",
            "city": "Waukesha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531861871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "DIZON",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laura Ann Rolerat, OTR
• Lucia C Roman-Marcial, M.D.
• Adam Nathaniel Romanski, DPT
• Renee M Romfoe, OTR
• Eyal D Ron, MD
• Erin Marie Rooney-Godin
• Emilie Roper
• James Allen Ropicky, D.C., DACRB, CCSP
• Charlene M Rosandich, BSN, RN
• Kathryn Rose

• Occupational Medicine Physician in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Occupational Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.