Neil James Rennick, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26462 Issued in WI

Practice address

3066 Main St # 45
East Troy, WI 53120-1148

Phone

(262) 642-7313

Fax

(262) 642-4251

NPI assigned

Jun 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
• Aurora Lakeland Medical Center Hospital, Elkhorn, WI, CCN 520102

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Family Medicine & Surgery LLC

  • General Practice Physician
  • East Troy, WI
  • NPI 1922305077
  Medicare reassignment NPD Authorized official

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

• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Elkhorn, WI
  • NPI 1972628006
  Care Compare affiliation
• Prohealth Waukesha Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1629056890
  Care Compare affiliation

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1508062043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45",
            "address_2": "3066 MAIN ST",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531200045",
            "telephone_number": "262-642-7313",
            "fax_number": "262-642-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 MAIN ST # 45",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531201148",
            "telephone_number": "262-642-7313",
            "fax_number": "262-642-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNICK",
        "first_name": "NEIL",
        "middle_name": "JAMES",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "26462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "26462",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30100300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory A Nyffeler, DDS
• Tracy Ojeda, M.S. ED
• Koren Pehkonen
• Trisha M Peterson, PTA
• Jessica D Prohuska, L.AC
• Albertina Tommaso Ricci, DO
• Rebecca Rohrer, RN
• Wanda Rott, RN
• Stacey Rudolph, RDH
• Sarah Scheblein

• Family Medicine Physician in East Troy, WI
• Providers in East Troy, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.