Active NPI
Wadad Fayez Ailabouni, MD
- Nephrology Physician
- Marshfield, WI
National Provider Identifier
1811196355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 34955
- Practice address
- 1000 N Oak Ave
Marshfield, WI 54449-5703 - Phone
- (715) 389-0636
- Fax
- (715) 387-5240
- NPI assigned
- Jul 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 34955 | WI | Primary |
Addresses
Primary practice location
1000 N Oak Ave
Marshfield, WI 54449-5703
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 389-0636
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | him@marshfieldclinichealthsystem.cernerdirect.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080707000402 | WI | Practitioner - Nephrology | 7911093414 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- MCHS Hospitals Inc
Practice addresses (Care Compare)
1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511
220 24TH St S
Wisconsin Rapids, WI 54494-1908
Phone (715) 751-6200
Hospital & facility affiliations
- DaVita Wisconsin Rapids Dialysis
- Marshfield Medical Center
- Marshfield Medical Center - Neillsville
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34955 | WI | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Marshfield Clinic Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| A T Ordinario Jr MD LLC | Nephrology | Past | Accepting new patients |
| Memorial Hospital Inc | Past | Accepting new patients |
Locations
3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200
1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
1020 Lakeshore Dr
Rice Lake, WI 54868
Phone (715) 236-8100
220 24th St S
Wisconsin Rapids, WI 54494
Phone (715) 424-8600
Interoperability endpoints
- wadad.ailabouni@marshfieldclinichealthsystem.cernerdirect.com
- him@marshfieldclinichealthsystem.cernerdirect.com
Organizations & group practices 6
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.
-
- Durable Medical Equipment & Medical Supplies
- Eau Claire, WI
- NPI 1558230847
-
- Critical Access Hospital
- Ladysmith, WI
- NPI 1952890873
-
- Rural Health Clinic/Center
- Neillsville, WI
- NPI 1619966793
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Wisconsin Rapids, WI
- NPI 1790075091
Dialysis facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1811196355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495703",
"telephone_number": "715-389-0636",
"fax_number": "715-387-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495703",
"telephone_number": "715-389-0636",
"fax_number": "715-387-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AILABOUNI",
"first_name": "WADAD",
"middle_name": "FAYEZ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-15",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "WI",
"license": "34955",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
"affiliation": "N",
"address_1": "1000 N Oak Ave",
"city": "Marshfield",
"state": "WI",
"country_code": "US",
"postal_code": "544495702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marshfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.