NPIMap

Individual provider Active NPI

Daniel S Wientzen, DO

  • Family Medicine Physician
  • Decorah, IA
National Provider Identifier
1952417248
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3864 Issued in IA
Practice address
1830 State Highway 9
Decorah, IA 52101-7301
Phone
(563) 382-3140
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-R-8208 IA
Family Medicine Physician 207Q00000X 3864 IA Primary

Addresses

Primary practice location

1830 State Highway 9
Decorah, IA 52101-7301

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20080222000585 IA Practitioner - Family PracticePractitioner - Emergency Medicine 7517041981 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians
Gundersen Regional Clinics, LLCGroup PAC ID 8820450919, 51 clinicians

Practice addresses (Care Compare)

1830 State Hwy 9
Decorah, IA 52101-7301
Phone (563) 382-3140

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions74
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3864IAMDFamily Medicine Physician
DO-R-8208IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Broadlawns Medical Center Current Accepting new patients
Broadlawns Medical Center CurrentSince Mar 4, 2013 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 3, 2009 Accepting new patients
Broadlawns Medical Center CurrentSince Mar 4, 2013 Accepting new patients
Gundersen Regional Clinics, LLC CurrentSince Oct 1, 2023 Accepting new patients
Gundersen Regional Clinics LLC Family Medicine CurrentSince Oct 1, 2023 Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 3, 2009 Accepting new patients

Locations

235 8th Ave W
Cresco, IA 52136
Phone (319) 547-2101

1830 State Highway 9
Ste 100
Decorah, IA 52101
Phone (563) 382-3140

1830 State Highway 9
Decorah, IA 52101
Phone (563) 382-2639

1801 Hickman Rd
Des Moines, IA 50314
Phone (515) 282-2200

1801 Hickman Rd
Ofc
Des Moines, IA 50314

201 8th Ave SE
Oelwein, IA 50662
Phone (319) 283-4321

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

Interoperability endpoints

  • Direct secure messaging: dwientzen13875@direct.emplifyhealth.org

Organizations & group practices 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1952417248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 STATE HIGHWAY 9",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521017301",
            "telephone_number": "563-382-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIENTZEN",
        "first_name": "DANIEL",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "DO-R-8208",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decorah, IA

Sources for this page

Verify at the official NPI Registry.