NPIMap

Individual provider Active NPI

Clarissa J Renken, DO

  • Family Medicine Physician
  • Wausau, WI
National Provider Identifier
1861636375
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
54752-21 Issued in WI
Practice address
2720 Plaza Dr
Suite 1300
Wausau, WI 54401-4158
Phone
(715) 847-2630
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WI
Family Medicine Physician 207Q00000X 54752-21 WI Primary

Addresses

Primary practice location

2720 Plaza Dr
Suite 1300
Wausau, WI 54401-4158

Mailing address

2720 Plaza Dr
Suite 1300
Wausau, WI 54401-4158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120814000412 WI Practitioner - Family Practice 6901052562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus Wausau Hospital IncGroup PAC ID 6406757442, 242 clinicians

Practice addresses (Care Compare)

333 Pine Ridge Blvd
Wausau, WI 54401-4102

Hospital & facility affiliations

  • Aspirus at Home Home health agency, Wausau, WI, CCN 527016
  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
  • Langlade Hospital Hospital, Antigo, WI, CCN 521350

Merit-based Incentive Payment System (MIPS)

Final score
90.56 of 100Reported as group
Quality
87.43
Promoting interoperability
100
Improvement activities
40
Cost
78.24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54752-21WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Wausau Hospital Inc CurrentSince Aug 15, 2012 Accepting new patients
Aspirus Wausau Hospital, Inc. Current Accepting new patients
Aspirus Wausau Hospital, Inc. CurrentSince Aug 15, 2012 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

2720 Plaza Dr
Ste 1300
Wausau, WI 54401
Phone (715) 847-2630

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

Organizations & group practices 3

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1861636375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 PLAZA DR",
            "address_2": "SUITE 1300",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 PLAZA DR",
            "address_2": "SUITE 1300",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014158",
            "telephone_number": "715-847-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENKEN",
        "first_name": "CLARISSA",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "54752-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.