Eva T Matanguihan, MD
Individual provider Active NPI Pediatrics Physician · Wisconsin Rapids, WI
NPI 1508878802 · NPPES record last updated Apr 11, 2012
Key facts
- NPI
- 1508878802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 36788 (WI)
- Practice address
- 2031 Peach St
Wisconsin Rapids, WI 54494-5181 - Phone
- (715) 423-0122
- NPI assigned
- Aug 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051129000828 | WI | Practitioner - Pediatric Medicine | 5597755751 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspirus Wausau Hospital, Inc. | Current | Accepting new patients | |
| Aspirus Wausau Hospital, Inc. | Current |
Accepting new patients | |
| Aspirus Medical Group, Inc. | Current |
Accepting new patients | |
| Aspirus Riverview Hospital & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Medical Group, Inc. | Current |
Accepting new patients | |
| Aspirus Wausau Hospital, Inc. | Current |
Accepting new patients | |
| Aspirus Medical Group, Inc. | Current | Accepting new patients | |
| Aspirus Riverview Hospital & Clinics, Inc. | Current |
Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
501 Aurora St
Antigo, WI 54409
Phone (715) 623-2331
333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160
2720 Plaza Dr
Ste 1400A
Wausau, WI 54401
Phone (715) 847-0426
4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400
420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474
2031 Peach St
Wisconsin Rapids, WI 54494
Phone (715) 423-0122
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 36788 | WI | Yes |
Addresses
Primary practice location
2031 Peach St
Wisconsin Rapids, WI 54494-5181
Mailing address
2031 Peach St
Wisconsin Rapids, WI 54494-5181
Phone (715) 423-0122
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32164100 | Medicaid | WI |
Other providers in Wisconsin Rapids, WI
- Bethany Lynn Marceau
- Marshfield Clinic
- Marshfield Clinic
- Kim Marie Marth
- Lynn Ann Martin
- Dana Sue Mathis
- Jessica Mattheis
- Heather Lisa McCarthy
- Elizabeth Pauline McCarville
- Brenda Jo McClellan-Tilson
All providers in Wisconsin Rapids, WI · Pediatrics Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.