Individual provider Active NPI

Eric R Niendorf, MD

  • Diagnostic Radiology Physician
  • Eau Claire, WI
National Provider Identifier
1780685404
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
47740 Issued in MN
Practice address
1400 Bellinger St
Eau Claire, WI 54703-5222
Phone
(715) 883-8522
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 47740 MN
Diagnostic Radiology Physician 2085R0202X 64033 WI
Diagnostic Ultrasound Physician 2085U0001X 47740 MN
Diagnostic Radiology Physician 2085R0202X 47740 MN Primary

Addresses

Primary practice location

1400 Bellinger St
Eau Claire, WI 54703-5222

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (715) 838-3635

Other practice location 1

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 559-2171

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eniendorf32279@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, 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
I20050603000500 MN Practitioner - Diagnostic Radiology 2567414121 Reassigns benefits to 7 organizations
I20150601002261 WI Practitioner - Diagnostic Radiology 2567414121 Reassigns benefits to 12 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Wisconsin School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Northwest Wisconsin Region IncGroup PAC ID 4385553627, shared by 21 NPIs, 797 clinicians

Practice addresses (Care Compare)

1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222

Hospital & facility affiliations

  • Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
  • Mayo Clinic Health System-Red Cedar Inc Hospital, Menomonie, WI, CCN 521340
  • Mayo Clinic Health System-Northland Hospital, Barron, WI, CCN 521315
  • Mayo Clinic Health System Chippewa Valley Hospital, Bloomer, WI, CCN 521314
  • Mayo Clinic Health System Oakridge Hospital, Osseo, WI, CCN 521302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64033WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Oct 1, 2016 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-St James CurrentSince Mar 4, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Fairview Health Services Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Fairview Health Services CurrentSince Jan 1, 2014 Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2014 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Mar 8, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Oct 23, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Mar 4, 2018 Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2014 Accepting new patients
St. Croix Regional Medical Center CurrentSince May 7, 2015 Accepting new patients
Fairview Clinics Current Accepting new patients
St. Croix Regional Medical Center CurrentSince May 7, 2015 Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Mar 4, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Oct 23, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Mar 4, 2018 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 1, 2018 Accepting new patients
Fairview Clinics CurrentSince Jan 1, 2014 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Mar 8, 2017 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Oct 1, 2016 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients

Locations (25 of 28)

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

1501 Thompson St
Bloomer, WI 54724
Phone (715) 568-2000

1400 Bellinger St
Eau Claire, WI 54703
Phone (715) 838-3311

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

1221 Whipple St
Eau Claire, WI 54703
Phone (715) 831-0100

403 N Maple St
Ellsworth, WI 54011
Phone (715) 273-5821

530 W Cairns St
Ellsworth, WI 54011
Phone (715) 273-5061

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156

2321 Stout Rd
Menomonie, WI 54751
Phone (715) 235-5531

13025 8th St
Osseo, WI 54758
Phone (715) 597-2575

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

705 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 357-2000

Interoperability endpoints

  • Direct secure messaging: eniendorf32279@ehrdirect.mayoclinicmsg.org

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 5

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": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1780685404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BELLINGER ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035222",
            "telephone_number": "715-883-8522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "554222926",
            "country_code": "US",
            "telephone_number": "763-559-2171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIENDORF",
        "first_name": "ERIC",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MN",
            "license": "47740",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "64033",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MN",
            "license": "47740",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "47740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eniendorf32279@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1400 Bellinger St",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547035222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.