NPIMap

Individual provider Active NPI

Martin J. Cristanelli, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Iron Mountain, MI
National Provider Identifier
1952474983
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301096312 Issued in MI
Practice address
1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone
(906) 774-1313
Fax
(906) 776-5639
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301096312 MI Primary
Cytopathology Physician 207ZC0500X 4301096312 MI

Addresses

Primary practice location

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637

Mailing address

PO Box 549
Iron Mountain, MI 49801-0549
Phone (906) 774-1313

Other identifiers 2

IdentifierTypeStateIssuer
P00853355OtherMIRR MEDICARE PIN
0220034OtherMIBCBS MI PIN

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
I20200213000257 WI Practitioner - Pathology 9032142872 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301096312MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc CurrentSince Feb 3, 2020 Accepting new patients
Beaver Dam Community Hospitals Inc Current Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Feb 3, 2020 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
MCHS Hospitals Inc CurrentSince Feb 3, 2020 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Feb 3, 2020 Accepting new patients
Memorial Hospital Inc CurrentSince Feb 3, 2020 Accepting new patients
Marshfield Clinic Inc CurrentSince Feb 3, 2020 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Feb 3, 2020 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Feb 3, 2020 Accepting new patients

Locations

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: martin.cristanelli@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1952474983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498010549",
            "telephone_number": "906-774-1313",
            "fax_number": "906-776-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-774-1313",
            "fax_number": "906-776-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTANELLI",
        "first_name": "MARTIN",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301096312",
            "primary": true
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "MI",
            "license": "4301096312",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00853355",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI PIN",
            "identifier": "0220034",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.