NPIMap

Individual provider Active NPI

Dominic Theodore Gomez Leonardelli, MD

  • Orthopaedic Hand Surgery Physician
  • Wausau, WI
National Provider Identifier
1992966493
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
53408-20 Issued in WI
Practice address
225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950
Phone
(715) 359-6442
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
Yes

Organizations & group practices 6

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 11

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

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Creighton University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bone and Joint Clinic S.C. 45 clinicians

Practice addresses (Care Compare)

225000 Hummingbird Rd
Suite 100
Wausau, WI 54401-2950
Phone (715) 359-6442

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030
  • Marshfield Medical Center - Weston Hospital, Weston, WI, CCN 520202

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20240709001968 WI Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 0042433393 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53408-20WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bone & Joint Clinic S.C. CurrentSince Jul 29, 2024 Accepting new patients
Bone & Joint Clinic S.C. Orthopaedic Surgery CurrentSince Jul 29, 2024 Accepting new patients
Bjosc, LLC Past Accepting new patients

Locations

724 S 8th St
Medford, WI 54451
Phone (715) 748-2663

100 S Eagle Dr
Merrill, WI 54452
Phone (715) 358-1911

1767 Park Ave
Ste 300
Plover, WI 54467
Phone (715) 344-1260

1767 Park Ave
#100
Plover, WI 54467
Phone (715) 344-1260

225000 Hummingbird Rd
Ste 300
Rib Mountain, WI 54401
Phone (715) 359-7592

225000 Hummingbird Rd
Ste 100
Rib Mountain, WI 54401
Phone 71535964421615

400 Westwood Dr
#200
Wausau, WI 54401
Phone (715) 261-0425

400 Westwood Dr
#100
Wausau, WI 54401
Phone (715) 393-0372

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Orthopaedic Surgery Physician 207X00000X 55350 AZ
Orthopaedic Surgery Physician 207X00000X 53408-20 WI
Orthopaedic Hand Surgery Physician 207XS0106X 53408-20 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

225000 Hummingbird Rd Ste 100
Wausau, WI 54401-2950

Mailing address

2924 Night Watch Way
Alpine, CA 91901-4115
Phone (719) 671-9277

Other practice location 1

34800 Bob Wilson Dr
Nmcsd
San Diego, CA 92134-1098
Phone (888) 607-4958

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 17, 2024.

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1992966493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 NIGHT WATCH WAY",
            "city": "ALPINE",
            "state": "CA",
            "postal_code": "919014115",
            "telephone_number": "719-671-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225000 HUMMINGBIRD RD STE 100",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544012950",
            "telephone_number": "715-359-6442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_2": "NMCSD",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "888-607-4958",
            "fax_number": "619-532-5846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ LEONARDELLI",
        "first_name": "DOMINIC",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "55350",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "53408-20",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "WI",
            "license": "53408-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.