Gina Marie Degiovanni, M.D.
Individual provider Active NPI Family Medicine Physician · Prairie Du Sac, WI
NPI 1861644940 · NPPES record last updated Feb 1, 2023
Key facts
- NPI
- 1861644940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 55307-020 (WI)
- Practice address
- 295 Water St
Prairie Du Sac, WI 53578-1332 - Phone
- (773) 330-6502
- NPI assigned
- Oct 21, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150729007820 | WI | Practitioner - Family Practice |
2769796135 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55307-020 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reedsburg Area Medical Center, Inc. | Family Medicine | Current |
Accepting new patients |
| Reedsburg Area Medical Center Inc | Current |
Accepting new patients | |
| Reedsburg Area Medical Center, Inc. | Current | Accepting new patients |
Locations
2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487
1900 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6477
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 55307-020 | WI | Yes |
Addresses
Primary practice location
295 Water St
Prairie Du Sac, WI 53578-1332
Mailing address
295 Water St
Prairie Du Sac, WI 53578-1332
Phone (773) 330-6502
Other providers in Prairie Du Sac, WI
- Mihal Davis
- Dean Health Systems, Inc.
- Dean Health Systems, Inc.
- Dean Retail Services Inc
- Henry Clay Dean V
- Elizabeth Christine Deroche
- Gregory Dezell
- Bridget Ann Dollar
- E-Scripts, Inc
- E-Scripts, Inc
All providers in Prairie Du Sac, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.