NPIMap

Individual provider Active NPI

Devon Sanger Dannen, M.D.

  • Family Medicine Physician
  • Hayward, WI
National Provider Identifier
1649447467
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56376 Issued in WI
Practice address
11040 N State Rd 77
Hayward, WI 54843-3603
Phone
(715) 934-4910
Fax
(715) 934-4620
NPI assigned
May 12, 2008
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 56376 WI Primary

Addresses

Primary practice location

11040 N State Rd 77
Hayward, WI 54843-3603

Mailing address

11040 N State Rd 77
Hayward, WI 54843-3606
Phone (715) 934-4910

Other identifiers 5

IdentifierTypeStateIssuer
1649447467OtherMNBCBS
P00767181OtherMEDICARE RAILROAD
0137428OtherMEDICA
1649447467OtherWIGROUP HEALTH
1649447467MedicaidMN

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
I20120117000142 WI Practitioner - Family Practice 3678619871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Services, IncGroup PAC ID 9436061363, 32 clinicians

Practice addresses (Care Compare)

11040 N State Rd
Hayward, WI 54843-6391
Phone (715) 934-4245

11040 N State Rd
Suite 77
Hayward, WI 54843-3606

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.05 of 100Reported as group
Quality
87.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56376WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Services, Inc CurrentSince May 1, 2022 Accepting new patients
Medical Services, Inc CurrentSince May 1, 2022 Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients
Medical Services, Inc Past Accepting new patients

Locations

11040 N State Road 77
Hayward, WI 54843
Phone (715) 934-4244

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1649447467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 N STATE RD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433606",
            "telephone_number": "715-934-4910",
            "fax_number": "715-934-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 N STATE RD 77",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433603",
            "telephone_number": "715-934-4910",
            "fax_number": "715-934-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNEN",
        "first_name": "DEVON",
        "middle_name": "SANGER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "56376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1649447467",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00767181",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0137428",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "1649447467",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649447467",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, WI

Sources for this page

Verify at the official NPI Registry.