NPIMap

Individual provider Active NPI

Clifford Robert Poplar, M.D.

  • Internal Medicine Physician
  • Delavan, WI
National Provider Identifier
1942396718
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28415 Issued in WI
Practice address
915 Geneva Street
Delavan, WI 53115
Phone
(262) 728-2651
Fax
(262) 728-2728
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28415 WI Primary

Addresses

Primary practice location

915 Geneva Street
Delavan, WI 53115

Mailing address

915 E Geneva St
PO Box 467
Delavan, WI 53115-1922
Phone (262) 728-2651

Other identifiers 1

IdentifierTypeStateIssuer
30856400MedicaidWI

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
I20080829000234 WI Practitioner - Internal Medicine 5294801130 Practice locations: Delavan, WI

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

915 E Geneva St
Delavan, WI 53115-1922
Phone (262) 728-2651

915 E Geneva St
PO Box 467
Delavan, WI 53115-0467

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Transitions Home Health Home health agency, Elkhorn, WI, CCN 527325
  • Aurora at Home Hospice, Wauwatosa, WI, CCN 521528
  • Aurora Lakeland Medical Center Hospital, Elkhorn, WI, CCN 520102
  • Aurora Memorial Hospital Burlington Hospital, Burlington, WI, CCN 520059
  • Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Golden Years of Lake Geneva Nursing home, Lake Geneva, WI, CCN 525727
  • Lakeland Health Care Ctr Nursing home, Elkhorn, WI, CCN 525625
  • Delavan Health Services Nursing home, Delavan, WI, CCN 525324
  • Holton Manor Nursing home, Elkhorn, WI, CCN 525541

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions27
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28415WIMDInternal Medicine Physician

Hospital & facility affiliations 12

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1942396718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 E GENEVA ST",
            "address_2": "PO BOX 467",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151922",
            "telephone_number": "262-728-2651",
            "fax_number": "262-728-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GENEVA STREET",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "53115",
            "telephone_number": "262-728-2651",
            "fax_number": "262-728-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPLAR",
        "first_name": "CLIFFORD",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "28415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30856400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delavan, WI

Sources for this page

Verify at the official NPI Registry.