NPIMap

Individual provider Active NPI

Raquel Abengozar Mingorance, MD

  • Student in an Organized Health Care Education/Training Program
  • Marshfield, WI
National Provider Identifier
1609437755
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone
(201) 705-4301
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

1000 N Oak Ave
Marshfield, WI 54449-5703

Mailing address

154 S Central Ave # D
Marshfield, WI 54449-2833
Phone (201) 705-4301

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
I20241209002875 WI Practitioner - General Surgery 6507278926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sauk Prairie Healthcare Inc 122 clinicians

Practice addresses (Care Compare)

260 26TH St
Prairie Du Sac, WI 53578-2203
Phone (608) 643-7574

Hospital & facility affiliations

  • Sauk Prairie Hospital Hospital, Prairie Du Sac, WI, CCN 520095

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux33
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sauk Prairie Healthcare Inc Single Specialty CurrentSince Oct 5, 2024 Accepting new patients
Sauk Prairie Healthcare Inc Single Specialty Current Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Sauk Prairie Healthcare Inc Single Specialty Current Accepting new patients
Sauk Prairie Healthcare, Inc. Single Specialty CurrentSince Oct 5, 2024 Accepting new patients
Surgical Associates Single Specialty Past Accepting new patients
Sauk Prairie Healthcare Inc Single Specialty Past Accepting new patients

Locations

260 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2471

250 26th St
Prairie du Sac, WI 53578
Phone (608) 643-2431

Interoperability endpoints

  • Direct secure messaging: rabengozarmingorance525632@direct-ehr-ssmhc.com
  • Direct secure messaging: rabengozarmingorance1117553@direct.unitypoint.org
  • Direct secure messaging: raquel.abengozar@direct.saukprairiehealthcare.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/9971/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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 1

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": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1609437755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 S CENTRAL AVE # D",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544492833",
            "telephone_number": "201-705-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "201-705-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABENGOZAR MINGORANCE",
        "first_name": "RAQUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.