Individual provider Active NPI

Paul M Segal, MD

  • Dermatology Physician
  • Beloit, WI
National Provider Identifier
1720097165
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25425020 Issued in WI
Practice address
1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone
(608) 364-1219
Fax
(608) 364-1280
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25425020 WI Primary
Dermatology Physician 207N00000X 036-075374 IL

Addresses

Primary practice location

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842

Mailing address

1905 E. Huebbe Parkway
Beloit Health System Inc
Beloit, WI 53511-1842
Phone (608) 364-1219

Other identifiers 1

IdentifierTypeStateIssuer
1720097165MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071226000106 IL Practitioner - Dermatology 4082526595 Reassigns benefits to 1 organization
I20100327000286 WI Practitioner - Dermatology 4082526595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Washington University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beloit Health System IncGroup PAC ID 8224947858, shared by 4 NPIs, 138 clinicians

Practice addresses (Care Compare)

1735 Madison Rd
Beloit, WI 53511-3216
Phone (608) 363-7510

1905 E Huebbe Pkwy
Beloit, WI 53511-1842
Phone (608) 363-5000

5601 E Rockton Rd
Roscoe, IL 61073-7601
Phone (815) 525-4800

5605 E Rockton Rd
Roscoe, IL 61073-7641
Phone (608) 364-5011

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.93 of 100Reported as group
Quality
64.82
Promoting interoperability
100
Improvement activities
40
Cost
71.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision151
Removal of skin lesions3243
Removal or shaving of skin growth18
Skin biopsy252

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-075374ILMDDermatology Physician
25425020WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Clinic, S.C. CurrentSince Jan 1, 2001 Accepting new patients
Beloit Health System, Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System Inc CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System Inc Dermatology CurrentSince Jan 1, 2010 Accepting new patients
Beloit Health System, Inc Past Accepting new patients

Locations

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

Organizations & group practices 5

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 1

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1720097165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-1219",
            "fax_number": "608-364-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 E. HUEBBE PARKWAY",
            "address_2": "BELOIT HEALTH SYSTEM INC",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111842",
            "telephone_number": "608-364-1219",
            "fax_number": "608-364-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "PAUL",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "25425020",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-075374",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720097165",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.