Individual provider Active NPI

Dawn Fifarek, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Oconto Falls, WI
National Provider Identifier
1821073818
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
94387-030 Issued in WI
Practice address
855 S Main St
Oconto Falls, WI 54154-1241
Phone
(920) 846-3444
NPI assigned
Dec 13, 2005
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 94387-030 WI Primary

Addresses

Primary practice location

855 S Main St
Oconto Falls, WI 54154-1241

Mailing address

855 S Main St
Oconto Falls, WI 54154-1241
Phone (920) 846-3444

Other identifiers 1

IdentifierTypeStateIssuer
045414OtherCRNA RECERTIFICATION CARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dfifarek22836@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412000607 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5395782338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Bay Anesthesia Assoc. SCGroup PAC ID 4486613858, 70 clinicians

Practice addresses (Care Compare)

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.22 of 100Reported as group
Quality
69.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
94387-030WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Green Bay Anesthesia Assoc. SC CurrentSince Sep 1, 2017 Accepting new patients
Aurora Medical Center Bay Area, Inc CurrentSince Jan 1, 2005 Accepting new patients
Nurse Anesthesia Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2013 Accepting new patients
St Clare Memorial Hospital, Inc. Past Accepting new patients
Aurora Medical Center Bay Area, Inc Past Accepting new patients
Green Bay Surgical Center Past Accepting new patients
Millenium Anesthesiologists, LTD. Past Accepting new patients
Tower Clock Surgery Center LLC Past Accepting new patients

Locations

1077 W Mason St
Green Bay, WI 54303
Phone (920) 497-1810

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

3100 Shore Dr
Marinette, WI 54143
Phone (715) 735-4200

3100 Shore Dr
Ste 106
Marinette, WI 54143
Phone (715) 732-8230

3100 Shore Dr
Ste 111
Marinette, WI 54143
Phone (715) 732-8212

Bin 88263
Milwaukee, WI 53288

425 S Commercial St
Neenah, WI 54956
Phone (920) 725-0700

Interoperability endpoints

  • Direct secure messaging: dfifarek22836@ewd.direct.hshs.org

Organizations & group practices 8

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 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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1821073818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S MAIN ST",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541241",
            "telephone_number": "920-846-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S MAIN ST",
            "city": "OCONTO FALLS",
            "state": "WI",
            "postal_code": "541541241",
            "telephone_number": "920-846-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFAREK",
        "first_name": "DAWN",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "94387-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA RECERTIFICATION CARD",
            "identifier": "045414",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dfifarek22836@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "855 S Main St",
            "city": "Oconto Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541541241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oconto Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.