Individual provider Active NPI

Joseph McCauslin, DO

  • Diagnostic Radiology Physician
  • Antigo, WI
National Provider Identifier
1750445474
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
37627 Issued in WI
Practice address
112 E 5TH Ave
Antigo, WI 54409-2710
Phone
(715) 623-2331
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 37627 WI Primary

Addresses

Primary practice location

112 E 5TH Ave
Antigo, WI 54409-2710

Mailing address

112 E 5TH Ave
Antigo, WI 54409-2710
Phone (715) 623-2331

Other identifiers 1

IdentifierTypeStateIssuer
30069100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37627WIMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1750445474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E 5TH AVE",
            "city": "ANTIGO",
            "state": "WI",
            "postal_code": "544092710",
            "telephone_number": "715-623-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAUSLIN",
        "first_name": "JOSEPH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "37627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30069100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Antigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.