Individual provider Active NPI

Kevin M Bluemel, MD

  • Family Medicine Physician
  • Brodhead, WI
National Provider Identifier
1689697260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36891 Issued in WI
Practice address
2310 1St Center Ave
Brodhead, WI 53520-1937
Phone
(608) 897-8664
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 36891 WI Primary

Addresses

Primary practice location

2310 1St Center Ave
Brodhead, WI 53520-1937

Mailing address

2310 1St Center Ave
Brodhead, WI 53520-1937
Phone (608) 897-8664

Other identifiers 1

IdentifierTypeStateIssuer
32173800MedicaidWI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041102001010 WI Practitioner - Family Practice 7517929482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

2310 1St Ctr Ave
Brodhead, WI 53520-1937
Phone (608) 897-8664

Hospital & facility affiliations

  • Mercyhealth at Home Home health agency, Janesville, WI, CCN 527018
  • Mercy Health System Corp Hospital, Janesville, WI, CCN 520066
  • University of Wi Hospitals & Clinics Authority Hospital, Madison, WI, CCN 520098
  • The Monroe Clinic Hospital, Monroe, WI, CCN 520028

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36891WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Nov 16, 1995 Accepting new patients
Mercy Health System Corporation CurrentSince Nov 16, 1995 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

2310 1st Center Ave
Brodhead, WI 53520
Phone (608) 897-8664

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

Interoperability endpoints

  • Direct secure messaging: kbluemel2395@direct.mhemail.org

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 and National Provider Directory roles.

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689697260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 1ST CENTER AVE",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535201937",
            "telephone_number": "608-897-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 1ST CENTER AVE",
            "city": "BRODHEAD",
            "state": "WI",
            "postal_code": "535201937",
            "telephone_number": "608-897-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUEMEL",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "36891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32173800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brodhead, WI

Sources for this page

Verify at the official NPI Registry.