Robert Joseph Defatta, MD, PH D, FACS

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

55984-20 Issued in WI

Practice address

1490 Rivers Edge Trail
Altoona, WI 54720-1495

Phone

(715) 828-2368

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 15

Addresses

Electronic endpoints 1

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

Otolaryngology

Education

Louisiana State University School of Medicine in New Orleans, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Defatta ENT and Facial Plastic Surgery SCGroup PAC ID 6103059936, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Black River Memorial Hospital Hospital, Black River Falls, WI, CCN 521333
• Marshfield Medical Center Hospital, Marshfield, WI, CCN 520037
• Oakleaf Surgical Hospital Hospital, Altoona, WI, CCN 520196

Merit-based Incentive Payment System (MIPS)

Final score

86.88 of 100Reported as group

Quality

85.49

Promoting interoperability

96

Improvement activities

40

Cost

74.1

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robertdefatta@defattaentfacialplastics.careclouddirect.com

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.

• Defatta ENT & Facial Plastic Surgery SC

  • Specialist
  • Altoona, WI
  • NPI 1346664059
  Medicare reassignment Care Compare group NPD Authorized official
• Advanced Surgical and Restorative Care LLC

  • Ambulatory Surgical Clinic/Center
  • Altoona, WI
  • NPI 1194466235
  NPD
• Advanced Surgical and Restorative Care LLC

  • Certified Registered Nurse Anesthetist
  • Altoona, WI
  • NPI 1952004863
  NPD

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

• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Care Compare affiliation
• MCHS Hospitals Inc

  • Rural Acute Care Hospital
  • Marshfield, WI
  • NPI 1942749387
  Care Compare affiliation
• Oak Leaf Surgical Hospital LLC

  • Special Hospital
  • Altoona, WI
  • NPI 1669463832
  Care Compare affiliation

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1578697520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 RIVERS EDGE TRAIL",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547201495",
            "telephone_number": "715-828-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 RIVERS EDGE TRAIL",
            "city": "ALTOONA",
            "state": "WI",
            "postal_code": "547201495",
            "telephone_number": "715-828-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFATTA",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD, PH D, FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "WI",
            "license": "55984",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "WI",
            "license": "55984",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WI",
            "license": "55984",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "WI",
            "license": "55984",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "WI",
            "license": "55984",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "WI",
            "license": "55984",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "243412",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "55984-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robertdefatta@defattaentfacialplastics.careclouddirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1490 Rivers Edge Trail",
            "city": "Altoona",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547201495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Austin J Crow, MD
• Taylor J Cunningham, PA
• Heather Dayton, ATC, LAT
• Defatta ENT & Facial Plastic Surgery SC
• Rima Abraham Defatta, M.D.
• Dax Demaree, D.O.
• Paul Joseph Dery, C.O.T.A.
• Jackson Detrick
• Ryan J Donegan, DPM
• Chastity Drake, LPC

• Otolaryngology Physician in Altoona, WI
• Providers in Altoona, WI by specialty
• Otolaryngology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.