Individual provider Active NPI

Gregory G Dodge, MD

  • Surgery Physician
  • Merrill, WI
National Provider Identifier
1497857171
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
33059 Issued in WI
Practice address
1205 O Day St
Merrill, WI 54452-3416
Phone
(715) 539-0179
NPI assigned
Sep 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 33059 WI Primary

Addresses

Primary practice location

1205 O Day St
Merrill, WI 54452-3416

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5777

Other identifiers 1

IdentifierTypeStateIssuer
32105600MedicaidWI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080620000451 WI Practitioner - General Surgery 2062583883 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Sanford School of Medicine of University of South Dakota, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Langlade Hospital - Hotel Dieu of St Joseph of Antigo WisconsinGroup PAC ID 1557271202, shared by 7 NPIs, 86 clinicians

Practice addresses (Care Compare)

110 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2351

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.2 of 100Reported as group
Quality
84.08
Promoting interoperability
100
Improvement activities
40
Cost
64.31

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33059WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Jan 1, 2023 Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin Current Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Mar 24, 2014 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin CurrentSince Mar 24, 2014 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Current Accepting new patients
Langlade Memorial Hospital Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

110 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2351

1205 O Day St
Merrill, WI 54452
Phone (715) 539-0101

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

604 S Webb St
Wittenberg, WI 54499
Phone (715) 253-2037

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497857171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 O DAY ST",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544523416",
            "telephone_number": "715-539-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "GREGORY",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "33059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32105600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrill, WI

Sources for this page

Verify at the official NPI Registry.