NPIMap

Individual provider Active NPI

Whitney Marie Van Reesen, M.D.

  • Family Medicine Physician
  • Lake Mills, WI
National Provider Identifier
1558780221
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
65144-20 Issued in WI
Practice address
1025 Mulberry St
Lake Mills, WI 53551
Phone
(920) 648-1451
Fax
(920) 648-1623
NPI assigned
Apr 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 65144-20 WI Primary

Addresses

Primary practice location

1025 Mulberry St
Lake Mills, WI 53551

Mailing address

1025 Mulberry St
Lake Mills, WI 53551-1304
Phone (920) 648-4518

Other names 1

  • Whitney Marie Vann Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170713003504 WI Practitioner - Family Practice 8123316585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1025 Mulberry St
Lake Mills, WI 53551-1304
Phone (920) 648-4518

111 Anna St
Waterloo, WI 53594-1184
Phone (920) 478-3776

1507 Doctors CT
Watertown, WI 53094-4101
Phone (920) 261-4111

540 Village Walk LN
Suite J
Johnson Creek, WI 53038-9554
Phone (920) 699-4388

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Watertown Physician Practices LLC Family Medicine CurrentSince Sep 4, 2018 Accepting new patients
Watertown Physician Practices LLC CurrentSince Sep 4, 2018 Accepting new patients

Locations

540 Village Walk Ln
Ste J
Johnson Creek, WI 53038
Phone (920) 699-4388

334 S Western Ave
Juneau, WI 53039
Phone (920) 261-9610

1025 Mulberry St
Lake Mills, WI 53551
Phone (920) 261-9591

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

Interoperability endpoints

  • Direct secure messaging: whitney.van.reesen.1@17022.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1558780221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MULBERRY ST",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535511304",
            "telephone_number": "920-648-4518",
            "fax_number": "920-648-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MULBERRY ST",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "53551",
            "telephone_number": "920-648-1451",
            "fax_number": "920-648-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN REESEN",
        "first_name": "WHITNEY",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "65144-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WHITNEY",
            "last_name": "VANN",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Mills, WI

Sources for this page

Verify at the official NPI Registry.