Individual provider Active NPI

Timothy Dean Bjelland, D.O.

  • Family Medicine Physician
  • Mauston, WI
National Provider Identifier
1811984305
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31519 Issued in WI
Practice address
1040 Division St
Mauston, WI 53948-1931
Phone
(608) 847-5000
NPI assigned
Sep 30, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31519 WI Primary

Addresses

Primary practice location

1040 Division St
Mauston, WI 53948-1931

Mailing address

1040 Division St
Mauston, WI 53948-1931

Other identifiers 1

IdentifierTypeStateIssuer
31624400MedicaidWI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100215000344 WI Practitioner - Family Practice 2567351034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mile Bluff Medical Center IncGroup PAC ID 8527971399, 87 clinicians

Practice addresses (Care Compare)

28 Commerce St
Wisconsin Dells, WI 53965-8293
Phone (608) 254-8888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31519WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mile Bluff Medical Center Inc CurrentSince Jan 1, 2015 Accepting new patients
Mile Bluff Medical Center Inc Current Accepting new patients
Mile Bluff Medical Center Inc CurrentSince Jan 1, 2015 Accepting new patients
Mile Bluff Clinic, LLP PastSince Dec 20, 1999 Accepting new patients

Locations

1515 Academy St
Elroy, WI 53929
Phone (608) 462-8414

1040 Division St
Mauston, WI 53948
Phone (608) 847-5000

1050 Division St
Mauston, WI 53948
Phone (608) 847-6161

28 Commerce St
Wisconsin Dells, WI 53965
Phone (608) 254-5888

Interoperability endpoints

  • Direct secure messaging: timothy.bjelland@direct.milebluff.com

Organizations & group practices 4

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 2

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811984305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "608-847-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BJELLAND",
        "first_name": "TIMOTHY",
        "middle_name": "DEAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "31519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31624400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauston, WI

Sources for this page

Verify at the official NPI Registry.