DR. PETER SCOTT DAHLBERG (NPI# 1750318218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750318218 |
| Entity Type | Individual |
| Full Name | DR. PETER SCOTT DAHLBERG |
| Credential | M.D. |
| Practice Address |
1100 Bergslien St Baldwin WI 54002 |
| Mailing Address |
1100 Bergslien St Baldwin WI 54002-2600 |
| Practice Telephone | 7156841111 |
| Mailing Telephone | 7156841111 |
| Mailing Fax Number | 7156841119 |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2018-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 36075 | MN | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 36075 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0085391 | 05 | |
| MN | PREFERRED ONE | 1028023 | 01 |
| WI | 34808300 | 05 | |
| MN | HEALTHPARTNERS | HP33647 | 01 |
| MN | BCBS | 110A6DA | 01 |
| MN | UCARE | 128184 | 01 |
| MN | 744218100 | 05 | |
| FM | MEDICA CHOICE & PRIMARY | 17-00867 | 01 |
| MN | ARAZ | 1344965 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013311216 | Peter J Dahlberg | Nurse Practitioner | 5400 Ward Rd Ste 110, Arvada, CO 80002 | 2014-10-16 |
| 1639252513 | Peter Joseph Dahlberg | Dentist | 6850 Brockton Ave Ste 106, Riverside, CA 92506-3814 | 2006-10-23 |
| Street Address |
1100 BERGSLIEN ST |
| City | BALDWIN |
| State | WI |
| Zip Code | 54002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245232982 | Christopher Converse Babbitt | Psychologist | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2005-08-12 |
| 1568076842 | Lindsey Jae Berg | Counselor | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2020-09-03 |
| 1558979112 | Alexandra Erickson | Occupational Therapist | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2020-07-20 |
| 1831712355 | Nicole Lee Samudio | Nurse Practitioner | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2020-05-19 |
| 1114567633 | Claire Bartlett | Physician Assistant | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2020-01-13 |
| 1598308025 | Morgan A Miller | Counselor | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2019-10-28 |
| 1508425356 | Brett Jensen | Specialist/Technologist | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2019-06-06 |
| 1053894840 | Katie Jo Carstens | Physician Assistant | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2018-09-08 |
| 1891277455 | Andrea Kay Burns | Nurse Practitioner | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2018-08-30 |
| 1790283265 | Kate Lynn Jones | Counselor | 1100 Bergslien St, Baldwin, WI 54002-2600 | 2018-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477099026 | Nichole Mattison | Radiologic Technologist | 1180 Oak St, Baldwin, WI 54002 | 2017-01-06 |
| 1497807929 | Dane L Rasmussen | Pharmacist | 840 Main St., Baldwin, WI 54002 | 2007-01-17 |
| 1114083912 | Douglas Earl Jacot | Chiropractor | 1640 Tenth Avenue, Baldwin, WI 54002 | 2006-12-28 |
| 1902907454 | Michael Lee Douglas | Family Medicine | 1110 Bergslien Street, Baldwin, WI 54002 | 2006-09-26 |
| 1427092196 | Shaima Sulemankhil | Family Medicine | 730 10th Ave., Baldwin, WI 54002 | 2006-06-15 |
| 1538114079 | Village of Baldwin | Ambulance | 630 Highway 12, Baldwin, WI 54002 | 2006-05-23 |
| 1861001083 | Marina Cheung Taylor | Physical Therapist | 990 Main Street, Suite #1, Baldwin, WI 54002 | 2020-07-23 |
| 1497245625 | Meghan Ann Becker | Physical Therapist | 650 Birch St, Baldwin, WI 54002 | 2018-05-14 |
| 1902108814 | Purdy Family Dentistry | Dentist | 1730 8th Avenue, Baldwin, WI 54002 | 2010-11-29 |
| 1861538472 | Susan Jayne Irek | Pharmacist | 840 Main Street, Baldwin, WI 54002 | 2007-01-30 |
| Find all providers in zip 54002 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558922575 | David Richard Healy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 900 W Clairemont Ave # West, Eau Claire, WI 54701-5105 | 2019-06-21 |
| 1225492986 | Mahmood Mirhoseini | Thoracic Surgery (Cardiothoracic Vascular Surgery) | N124w16862 Lovers Ln, Germantown, WI 53022-1924 | 2016-04-08 |
| 1427349075 | Amanda Leigh Eilers | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 425 Pine Ridge Blvd Ste 209, Wausau, WI 54401-4123 | 2011-04-29 |
| 1972730745 | Robert Cesar Gomez | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 63 Cambridge Rd, Madison, WI 53704-5961 | 2009-06-18 |
| 1518104470 | Green Bay Cardiothoracic & Vascular, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 720 So. Vanburen Street, Suite 303, Green Bay, WI 54301 | 2009-01-14 |
| 1790921930 | Salvior Mok | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1818 N Meade St Ste N347, Appleton, WI 54911-3454 | 2008-12-17 |
| 1942496724 | Anselmo A Nunez | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2600 Stewart Ave Ste 148, Wausau, WI 54401-1403 | 2007-09-14 |
| 1164510871 | George R. Reiss IIi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 700 S. Park St, Madison, WI 53715-1830 | 2006-10-10 |
| 1487667549 | Steven J Gerndt | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 720 S Webster Ave, Suite 303, Green Bay, WI 54301-3538 | 2006-08-13 |
| 1609889757 | Kevin A Greer | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 720 South Van Buren Street, Suite 303, Green Bay, WI 54301 | 2006-08-13 |
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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.