NPIMap

Individual provider Active NPI

Christopher M Mjaanes, MD

  • Allergy & Immunology Physician
  • Neenah, WI
National Provider Identifier
1972660306
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
34651300WI Issued in WI
Practice address
119 E Bell St
Neenah, WI 54956-4993
Phone
(920) 969-1768
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 34651300WI WI Primary

Addresses

Primary practice location

119 E Bell St
Neenah, WI 54956-4993

Mailing address

119 E Bell St
Neenah, WI 54956-4993
Phone (920) 969-1768

Other practice location 1

220 Bosworth Ln
Neenah, WI 54956-4976
Phone (920) 767-0546

Other identifiers 1

IdentifierTypeStateIssuer
34651300MedicaidWI

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
I20050705000838 WI Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 5092795922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
University of Wisconsin School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Specialists of Wisconsin SCGroup PAC ID 9830086925, 28 clinicians

Practice addresses (Care Compare)

119 E Bell St
Neenah, WI 54956-4993
Phone (920) 969-1768

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34651300WIWIMDAllergy & Immunology Physician

Organizations & group practices 1

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 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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972660306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E BELL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564993",
            "telephone_number": "920-969-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E BELL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549564993",
            "telephone_number": "920-969-1768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Bosworth Ln",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549564976",
            "country_code": "US",
            "telephone_number": "920-767-0546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MJAANES",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WI",
            "license": "34651300WI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34651300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.