NPIMap

Individual provider Active NPI

Kirubel Woldemichael, MD

  • Psychiatry Physician
  • Kronenwetter, WI
National Provider Identifier
1780145847
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
76277-20 Issued in WI
Practice address
825 Glade CT Apt 8
Kronenwetter, WI 54455-7335
Phone
(571) 426-9405
NPI assigned
Mar 29, 2019
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 76277-20 WI Primary

Addresses

Primary practice location

825 Glade CT Apt 8
Kronenwetter, WI 54455-7335

Mailing address

825 Glade CT Apt 8
Kronenwetter, WI 54455-7335
Phone (571) 426-9405

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
I20230802000446 WI Practitioner - PsychiatryPractitioner - Neurology 3577949536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
Medical College of Wisconsin, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone (715) 361-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76277-20WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Aug 15, 2023 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Aug 15, 2023 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-3000

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

Organizations & group practices 2

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1780145847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 GLADE CT APT 8",
            "city": "KRONENWETTER",
            "state": "WI",
            "postal_code": "544557335",
            "telephone_number": "571-426-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 GLADE CT APT 8",
            "city": "KRONENWETTER",
            "state": "WI",
            "postal_code": "544557335",
            "telephone_number": "571-426-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLDEMICHAEL",
        "first_name": "KIRUBEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "76277-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kronenwetter, WI

Sources for this page

Verify at the official NPI Registry.