Mia Farida Mediana Pingul, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

15279 Issued in WI

Practice address

1000 N Oak Ave
Marshfield, WI 54449-5703

Phone

(715) 387-5511

NPI assigned

Mar 27, 2007

Last updated

Jul 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mpingul186132@soc.inova.org
• Direct secure messaging: pedsendo@tagpros.org

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.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Pediatric Specialists of Virginia, LLC

  • Pediatrics Physician
  • Fairfax, VA
  • NPI 1699119818
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1851419857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 MAYLAND DR # 4782",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232944648",
            "telephone_number": "703-539-2172",
            "fax_number": "312-900-8148"
        },
        {
            "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": "715-387-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8401 Mayland Dr # 4782",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232944648",
            "country_code": "US",
            "telephone_number": "703-539-2172",
            "fax_number": "312-900-8148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINGUL",
        "first_name": "MIA FARIDA",
        "middle_name": "MEDIANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "VA",
            "license": "0101258508",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "WI",
            "license": "15279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pedsendo@tagpros.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "(312)900-8148",
            "address_1": "8401 Mayland Dr # 4782",
            "city": "Richmond",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232944648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Adam Petty, DDS
• Jackie R. Pfeifer, NP
• Tin D Pham, DPT
• Robert E Phillips, MD
• Petr Pikhut, MD
• Mythe Piper
• Pisces LLC
• Yonat Piva, LMFT
• Aliya Placeres, DO
• Callie Elizabeth Plafkin, M.D.

• Pediatric Endocrinology Physician in Marshfield, WI
• Providers in Marshfield, WI by specialty
• Pediatric Endocrinology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.