NPIMap

Individual provider Active NPI

Mark D Stannard, MD

  • Family Medicine Physician
  • Hudson, WI
National Provider Identifier
1700858933
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39942 Issued in WI
Practice address
2651 Hillcrest Drive
Hudson, WI 54016-4439
Phone
(715) 531-6800
Fax
(715) 531-6801
NPI assigned
Feb 2, 2006
Last updated
May 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 42574 MN
Family Medicine Physician 207Q00000X 39942 WI Primary

Addresses

Primary practice location

2651 Hillcrest Drive
Hudson, WI 54016-4439

Mailing address

2651 Hillcrest Drive
Suite 303
Hudson, WI 54016-7899
Phone (715) 531-6800

Other identifiers 1

IdentifierTypeStateIssuer
32437900MedicaidWI

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
I20050614000243 WI Practitioner - Family Practice 8527002286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Physicians SCGroup PAC ID 2668607557, 62 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Hudson, WI 54016-4439
Phone (715) 531-6800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions16
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42574MNMDFamily Medicine Physician
39942WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Physicians, S.C Family Medicine CurrentSince Oct 1, 2013 Accepting new patients
Hudson Physicians, S.C. Family Medicine CurrentSince Oct 1, 2013 Accepting new patients
Hudson Physicians, S.C. Family Medicine Current Accepting new patients
Guardian Hospice MN LLC Family Medicine PastSince May 1, 2024 Accepting new patients
Hudson Physicians, S.C. Past Accepting new patients
Bickford of Hugo, LLC Past Accepting new patients

Locations

840 Spruce St
Baldwin, WI 54002
Phone (715) 235-4274

2651 Hillcrest Dr
Hudson, WI 54016
Phone (630) 632-2648

2651 Hillcrest Dr
Ste 303
Hudson, WI 54016

403 Stageline Rd
Hudson, WI 54016
Phone (715) 386-8880

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/42a1ed53-a9ac-42b2-918f-be592f726951/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Moments HospiceGolden Valley, MN, CCN 241602 Hospice Contracted Managing Employee May 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1700858933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "address_2": "SUITE 303",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167899",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DRIVE",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANNARD",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "42574",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "39942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32437900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.