NPIMap

Organization Active NPI

Western Wisconsin Urology

  • Urology Physician
  • Eau Claire, WI
National Provider Identifier
1710060199
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
WESTERN WISCONSIN UROLOGY
Practice address
3217 Stein Blvd
Eau Claire, WI 54701-6995
Phone
(715) 835-6548
Fax
(715) 835-7708
NPI assigned
Oct 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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

Authorized official

Name
David J Katz, M.D.
Title
President
Phone
(715) 835-6548

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X WI
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

3217 Stein Blvd
Eau Claire, WI 54701-6995

Mailing address

3217 Stein Blvd
Eau Claire, WI 54701-6995
Phone (715) 835-6548

Other identifiers 1

IdentifierTypeStateIssuer
32666800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070815000804 WI Part B Supplier - Clinic/Group Practice 0648362012 Receives reassigned benefits from 7 practitioners
Practice locations: Spooner, WI; Turtle Lake, WI; Stanley, WI; Shell Lake, WI; Rice Lake, WI; Osceola, WI; Eau Claire, WI; Durand, WI…
O20091012000014 MN Part B Supplier - Clinic/Group Practice 0648362012 Receives reassigned benefits from 1 practitioner
Practice locations: Lake City, MN; Wabasha, MN
O20250224001038 WI DME Supplier - Physician - Urology 0648362012 Practice locations: Eau Claire, WI

National Provider Directory

National Provider Directory
Tax ID family
Western Wisconsin Urology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1200 5th Grant Blvd W
Wabasha, MN 55981
Phone (651) 565-4531

1202 Grant Blvd W
Wabasha, MN 55981

2655 County Highway I
#1
Chippewa Falls, WI 54729

3217 Stein Blvd
Eau Claire, WI 54701
Phone (715) 552-9679

105 4th Ave
Shell Lake, WI 54871
Phone (715) 468-2711

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1710060199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016995",
            "telephone_number": "715-835-6548",
            "fax_number": "715-835-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 STEIN BLVD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016995",
            "telephone_number": "715-835-6548",
            "fax_number": "715-835-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WISCONSIN UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-22",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "715-835-6548",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32666800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.