Dominic Theodore Cardelli, MD
Individual provider Active NPI Neurology Physician · Appleton, WI
NPI 1528077583 · NPPES record last updated Nov 30, 2010
Key facts
- NPI
- 1528077583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- 33613 (WI)
- Practice address
- 2500 E Enterprise Ave Ste E
Appleton, WI 54913-8557 - Phone
- (920) 968-5057
- Fax
- (920) 968-7248
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Samuel Mahelona Memorial Hospital
Practice addresses (Care Compare)
4489 Papalina Rd
Kalaheo, HI 96741-2001
Phone (808) 332-8523
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- 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 |
|---|---|---|---|---|
| I20250625001367 | HI | Practitioner - Neurology | 8628018587 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33613 | WI | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samuel Mahelona Memorial Hospital | Current |
Accepting new patients | |
| Samuel Mahelona Memorial Hospital | Current | Accepting new patients | |
| Kauai Veterans Memorial Hospital | Current |
Accepting new patients | |
| Kauai Veterans Memorial Hospital | Current | Accepting new patients | |
| Samuel Mahelona Memorial Hospital | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 33613 | WI | Yes |
| Neurology Physician | 2084N0400X | 38127 | MN |
Addresses
Primary practice location
2500 E Enterprise Ave Ste E
Appleton, WI 54913-8557
Mailing address
2500 E Enterprise Ave Ste E
Appleton, WI 54913-8557
Phone (920) 968-5057
Other providers in Appleton, WI
- Keegan Campbell
- Sarah C Campbell
- Mikayla Cann
- Kobi S Caracci
- Riley Caracci
- Care and Compassion Counseling, LLC
- Carepros, LLC
- Careride Mobility LLC
- Carevo Transport LLC
- Caring Hearts Personal Home Care LLC
All providers in Appleton, WI · Neurology 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 Nov 30, 2010. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.