MARK W NIEDFELDT, MD, LLC (NPI# 1174764906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174764906 |
| Entity Type | Organization |
| Organization Name | MARK W NIEDFELDT, MD, LLC |
| Practice Address |
10556 N Port Washington Rd Ste 101 Mequon WI 53092-5586 |
| Mailing Address |
10556 N Port Washington Rd Suite 101 Mequon WI 53092-5586 |
| Practice Telephone | 2626434720 |
| Practice Fax Number | 2626434721 |
| Mailing Telephone | 2626434720 |
| Mailing Fax Number | 2626434721 |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2009-03-06 |
| Authorized Official Name | DR. MARK W NIEDFELDT (OWNER) |
| Authorized Official Telephone | 2626434720 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
35201 | WI | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 35201 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
10556 N PORT WASHINGTON RD STE 101 |
| City | MEQUON |
| State | WI |
| Zip Code | 53092-5586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275911406 | Luke Laga | Acupuncturist | 10556 N Port Washington Rd, Mequon, WI 53092-5586 | 2015-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942790761 | Kathryn Mueller | Specialist/Technologist | 117 Linden Lane, Apt 7, Thiensville, WI 53092 | 2018-05-17 |
| 1427547082 | Shopko Stores Operating Co LLC | Eyewear Supplier (Equipment, not the service) | 10996 N Port Washington Rd, Mequon, WI 53092 | 2018-05-08 |
| 1912437252 | Froedtert & The Medical College of Wisconsin Community Physicians Inc | Durable Medical Equipment & Medical Supplies | 11430 Port Washington Road, Mequon, WI 53092 | 2017-06-19 |
| 1629437256 | Sean S Tsang | Acupuncturist | 909 W. Mequon Rd., Mequon, WI 53092 | 2016-02-10 |
| 1497128433 | Nancy Snoots | Counselor | 4430 W Tarrytown Ln, Mequon, WI 53092 | 2015-11-12 |
| 1609265214 | Evan Guettel | Physical Therapist | 11363 N. Port Washington Road, Mequon, WI 53092 | 2015-01-20 |
| 1881091148 | Sarah Krueger | Counselor | 216 N Green Bay Rd Suite 108, Thiensville, WI 53092 | 2014-12-01 |
| 1245667088 | Lora Transportation, LLC | Non-emergency Medical Transport (VAN) | 1228 West Baldwin Crt., Mequon, WI 53092 | 2013-10-10 |
| 1710314000 | Roxxi M Davis | Social Worker | 7113 Tamarack Ct, Mequon, WI 53092 | 2013-10-01 |
| 1225473713 | Forefront Dermatology, S.c. | Dermatology | 10303 N Port Washington Rd Ste 101, Mequon, WI 53092 | 2013-05-09 |
| Find all providers in zip 53092 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336227834 | Jeffrey T Sabatino | Family Medicine | 11725 N Port Washington Rd, Ste 250, Mequon, WI 53092-3485 | 2006-11-01 |
| 1326050436 | Nicola M. Charlton | Family Medicine | 11221 N Parkview Dr, Mequon, WI 53092-1923 | 2006-08-13 |
| 1316979552 | John J Yang | Family Medicine | 6425 W Mequon Road, Mequon, WI 53092 | 2006-07-07 |
| 1841230463 | John David Bivins II | Family Medicine | 12800 N Port Washington Rd, Mequon, WI 53097-2415 | 2006-06-08 |
| 1205887775 | Mark W Niedfeldt | Family Medicine | 10556 North Port Washington Road, Suite 101, Mequon, WI 53092-5586 | 2006-05-12 |
| 1639131998 | Paul J Mankus | Family Medicine | 10219 N Trillium Rd, Mequon, WI 53092-6174 | 2006-04-03 |
| 1306819305 | Richard Lewis | Family Medicine | 11649 N Port Washington Rd Ste 114, Your Md, Sc., Mequon, WI 53092-3461 | 2006-02-09 |
| 1598742652 | Michael Gerard | Family Medicine | 11430 N Port Washington Rd, Mequon, WI 53092-3414 | 2005-12-29 |
| 1144797614 | Ovation Hand Institute, LLC | Family Medicine | 10532 N Port Washington Rd, Mequon, WI 53092-5563 | 2018-11-01 |
| 1174018584 | Ashley A Mcguire | Family Medicine | 12203 Corporate Pkwy, Mequon, WI 53092 | 2018-06-27 |
| Find all providers in MEQUON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.