NPIMap

Organization Active NPI

Oakleaf Clinics Inc

Doing business as Oakleaf Clinics Dermatology

  • Dermatology Physician
  • Chippewa Falls, WI
National Provider Identifier
1639913973
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
OAKLEAF CLINICS INC
Doing business as
Oakleaf Clinics Dermatology
Practice address
2815 County Highway I
Chippewa Falls, WI 54729-2656
Phone
(715) 438-8255
Fax
(715) 720-0754
NPI assigned
Jun 21, 2024
Last updated
Jun 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Chris Longbella, MDNPI 1992804413
Title
Authorized Official
Phone
(715) 836-9242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

2815 County Highway I
Chippewa Falls, WI 54729-2656

Mailing address

719 W Hamilton Ave Ste B
Eau Claire, WI 54701-6970
Phone (715) 552-9784

Other names 1

  • Oakleaf Clinics Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110602000195 WI Part B Supplier - Clinic/Group Practice 4486831328 Receives reassigned benefits from 120 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rice Lake, WI; Menomonie, WI; Ladysmith, WI; Eau Claire, WI; Cornell, WI; Chippewa Falls, WI; Altoona, WI

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2173391Oakleaf Clinics- Dermapathology Chippewa Falls2815 County Highway I, 4TH Floor, Chippewa Falls, WI 54729ComplianceOct 21, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1639913973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W HAMILTON AVE STE B",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016970",
            "telephone_number": "715-552-9784",
            "fax_number": "715-835-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547292656",
            "telephone_number": "715-438-8255",
            "fax_number": "715-720-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLEAF CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "LONGBELLA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "715-836-9242",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakleaf Clinics Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.