Individual provider Active NPI

Sankalp Dwivedi

  • Gastroenterology Physician
  • Menasha, WI
National Provider Identifier
1902215759
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
71749 Issued in WI
Practice address
1550 Midway PL
Menasha, WI 54952-1165
Phone
(920) 738-2000
NPI assigned
Aug 6, 2014
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 71749 WI
Gastroenterology Physician 207RG0100X 71749 WI Primary

Addresses

Primary practice location

1550 Midway PL
Menasha, WI 54952-1165

Mailing address

1550 Midway PL
Menasha, WI 54952-1165
Phone (920) 738-2000

Other identifiers 1

IdentifierTypeStateIssuer
100099717MedicaidWI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200608003067 WI Practitioner - GastroenterologyPractitioner - Internal Medicine 6406165232 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1550 Midway PL
Menasha, WI 54952-1165
Phone (920) 738-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91
Upper gastrointestinal (GI) endoscopy for acid reflux105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71749WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Calumet Hospital, Inc CurrentSince Jul 5, 2020 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 2, 2020 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jun 2, 2020 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

1550 Midway Pl
Menasha, WI 54952
Phone (920) 727-8030

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

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.

Hospital & facility affiliations 2

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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1902215759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 MIDWAY PL",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521165",
            "telephone_number": "920-738-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 MIDWAY PL",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521165",
            "telephone_number": "920-738-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWIVEDI",
        "first_name": "SANKALP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "71749",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "71749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100099717",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.