NPIMap

Individual provider Active NPI

Edward M Wineck, MD

  • Diagnostic Radiology Physician
  • Duluth, MN
National Provider Identifier
1790711299
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
40390 Issued in WI
Practice address
400 E Third Street
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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 40390 WI Primary

Addresses

Primary practice location

400 E Third Street
Duluth, MN 55805-1951

Mailing address

2845 Greenbrier Rd
PO Box 8900
Green Bay, WI 54308-8900
Phone (920) 288-4930

Other practice location 1

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-4930

Other identifiers 1

IdentifierTypeStateIssuer
32490500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070410000282 WI Practitioner - Diagnostic Radiology 1254436868 Reassigns benefits to 3 organizations
I20181109001326 MN Practitioner - Diagnostic Radiology 1254436868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP CurrentSince Apr 1, 2007 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Oct 29, 2018 Accepting new patients
The Duluth Clinic, LTD CurrentSince Oct 29, 2018 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
Baycare Clinic LLP CurrentSince Apr 1, 2007 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
St. Mary's Hospital of Superior CurrentSince Oct 29, 2018 Accepting new patients
St Mary's Hospital of Superior CurrentSince Oct 29, 2018 Accepting new patients
The Duluth Clinic, LTD CurrentSince Oct 29, 2018 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Bay Area Imaging, S.C. Diagnostic Radiology PastSince Jan 1, 2003 Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

603 9th St N
Virginia, MN 55792
Phone (218) 741-3013

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

2845 Greenbrier Rd
#1
Green Bay, WI 54311
Phone (920) 288-8100

164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

2845 Greenbrier Rd
#4
Green Bay, WI 54311
Phone (920) 288-8400

15495 County Road B
Hayward, WI 54843
Phone (715) 634-2641

601 Reed Ave
Manitowoc, WI 54220
Phone (920) 682-8841

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 13

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 13

Hospital & facility affiliations 6

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1790711299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "address_2": "PO BOX 8900",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543088900",
            "telephone_number": "920-288-4930",
            "fax_number": "920-288-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E THIRD STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2845 Greenbrier Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116519",
            "country_code": "US",
            "telephone_number": "920-288-4930",
            "fax_number": "920-288-4941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINECK",
        "first_name": "EDWARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "40390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32490500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.