Active NPI
Irina Selezneva, MD
- Pediatrics Physician
- Rice Lake, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 47213
- Practice address
- 1700 W Stout St
Rice Lake, WI 54868-5000 - Phone
- (715) 236-8100
- NPI assigned
- Sep 20, 2006
- Last updated
- Sep 29, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 47213 | WI | Primary |
Addresses
Primary practice location
1700 W Stout St
Rice Lake, WI 54868-5000
Mailing address
1000 N Oak Ave
Marshfield, WI 54449-5777
Phone (715) 387-5511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34603500 | Medicaid | WI |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47213 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeview Medical Center Inc of Rice Lake | Current | Accepting new patients | |
| MCHS Hospitals Inc | Current | Accepting new patients | |
| Marshfield Clinic Inc | Current | Accepting new patients |
Locations
1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850
3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200
1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111
1020 Lakeshore Dr
Rice Lake, WI 54868
Phone (715) 236-8100
1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133
Interoperability endpoints
- irina.selezneva@marshfieldclinichealthsystem.cernerdirect.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Marshfield Medical Center - Rice Lake Professional Services
- Clinic/Center
- Rice Lake, WI
- NPI 1093201832
-
dba Marshfield Clinic Florida Teleradiology/Telehealth
- Clinic/Center
- Marshfield, WI
- NPI 1952347981
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254182400000",
"number": "1881791077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N OAK AVE",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544495777",
"telephone_number": "715-387-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 W STOUT ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548685000",
"telephone_number": "715-236-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELEZNEVA",
"first_name": "IRINA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2009-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "47213",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34603500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rice Lake, WI
- Lloyd Leland Schultz III, MS, LPC-IT
- Bethany Erin Schweiner
- Mildred Jean Seabold, MS, RD,CD
- Michael Seebruck, OD
- Lacey B. Seipp, COTA
- Jared Richard Sherman, PA-C
- Shopko Stores Operating Co LLC (ShopKo Pharmacy 132)
- Shopko Stores Operating Co. LLC (ShopKo Optical 132)
- Shoptikal LLC (Shopko Optical 4132)
- Sikorski Hearing Aid Center, Inc. (Sikorski Hearing and Tinnitus Wellness Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; 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.