Richard Gregg Kishaba, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

27007 Issued in WI

Practice address

733 W Clairemont Ave
Eau Claire, WI 54701-6101

Phone

(715) 838-5222

NPI assigned

Jan 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Pediatric Medicine

Education

Medical College of Wisconsin, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rkishaba23663@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Menomonie, WI
  • NPI 1154372944
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • Eau Claire, WI
  • NPI 1235588831
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Barron, WI
  • NPI 1740239557
  Medicare reassignment NPD
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Bloomer, WI
  • NPI 1700837812
  Medicare reassignment
• Mayo Clinic Health System-Northwest Wisconsin Region, Inc.

  • Rural Health Clinic/Center
  • Mondovi, WI
  • NPI 1174116669
  NPD

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1477532794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 W CLAIREMONT AVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016101",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHABA",
        "first_name": "RICHARD",
        "middle_name": "GREGG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "27007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkishaba23663@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "733 W Clairemont Ave",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547016101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Jeremy Kinsella, M.D.
• Katelyn Ingrid Kippes
• Kirby Physical Therapy, LLC
• Joseph M Kirst, NP
• Ruta M Kirstein, ANP
• Judith Ann Kistner, M.S.
• Joseph Kojo Kittah
• Kimberly Jean Kitzberger, SAC
• Clare Olivia Koopmans Klang, M.S. CCC-SLP
• Suzanne Mary Klauck

• Pediatrics Physician in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.
• 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.