Dianna Lea Bearse, D.O.
Individual provider Active NPI Family Medicine Physician · Platteville, WI
NPI 1770628612 · NPPES record last updated Nov 16, 2011
Key facts
- NPI
- 1770628612
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 56479 (WI)
- Practice address
- 1240 Big Jack Rd
Platteville, WI 53818-8902 - Phone
- (608) 348-6266
- Fax
- (608) 342-5600
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Medical Associates Clinic P C
Practice addresses (Care Compare)
1000 Langworthy St
Dubuque, IA 52001-7313
Phone (563) 584-4100
1240 Big Jack Rd
Platteville, WI 53818-8902
Phone (608) 348-6266
Hospital & facility affiliations
- Grant County Home Nursing Service
- St Croix Hospice Baraboo
- Agrace Hospicecare
- Southwest Health Center
- Grant Regional Health Center
- Mercyone Dubuque Medical Center
- Edenbrook of Platteville
- St Dominic Villa
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WI, IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120207000036 | WI | Practitioner - Family Practice | 2961562418 | Reassigns benefits to 1 organization |
| I20170201000254 | IA | Practitioner - Family Practice | 2961562418 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2216 | WV | MD | Dentist |
| 56479 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Associates Clinic P C | Current |
Accepting new patients | |
| Frederick Health Hospital Inc | Past | Accepting new patients |
Locations
1000 Langworthy St
Dubuque, IA 52001
Phone (563) 584-3455
1500 Associates Dr
Dubuque, IA 52002
Phone (563) 584-4100
1240 Big Jack Rd
Platteville, WI 53818
Phone (608) 348-2844
Interoperability endpoints
- dbearse258590@direct-ehr-ssmhc.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 56479 | WI | Yes |
Addresses
Primary practice location
1240 Big Jack Rd
Platteville, WI 53818-8902
Mailing address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100
NPI Registry JSON
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1770628612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ASSOCIATES DR",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520022201",
"telephone_number": "563-584-4100",
"fax_number": "563-584-4110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 BIG JACK RD",
"city": "PLATTEVILLE",
"state": "WI",
"postal_code": "538188902",
"telephone_number": "608-348-6266",
"fax_number": "608-342-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARSE",
"first_name": "DIANNA",
"middle_name": "LEA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "56479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Platteville, WI
- Jennifer Barraza
- Kori Barry
- Bruce Bartels
- Carrie Kate Bartels
- Jack Basten
- Jolene Kaye Beebe
- Jenny Belken
- Kari Kaye-Cattle Bell
- Clark Edward Benson
- Joanne Marie Beraldi
All providers in Platteville, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.