BRANDON DILLENBACK FNP
NPI 1275088072
Nurse Practitioner in Fond Du Lac, WI

Q: What is Brandon Dillenback's NPI number?

The NPI number for Brandon Dillenback is 1275088072. It was assigned to this individual provider in the NPPES registry on August 22, 2016.

Q: What is Brandon Dillenback's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since August 22, 2016PECOS EnrolledAccepts Medicare Assignment

420 E DIVISION ST, FOND DU LAC, WI 54935(920) 926-8573(920) 926-8923 Get Directions Write a Review

NPPES record last updated: August 3, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Brandon Dillenback Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRANDON DILLENBACK FNP (NPI 1275088072) is an individual nurse practitioner in Fond Du Lac, Wisconsin, licensed in Wisconsin (14338-33) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, is affiliated with St. Agnes Hospital Hospice, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1275088072

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameBRANDON DILLENBACKCredential: FNP

Location Address420 E DIVISION STFond Du Lac, WI 54935-4560

Mailing Address420 E Division StFond Du Lac, WI 54935-4560 · (920) 926-8573 · Fax (920) 926-8923

Phone(920) 926-8573

Fax(920) 926-8923

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateAugust 22, 2016

Last NPPES UpdateAugust 3, 2023

NPPES CertifiedAugust 3, 2023

✔ NPI 1275088072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in WI · 14338-33

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

420 E DIVISION ST, Fond Du Lac, WI 54935

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Quartz.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Brandon Dillenback Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880049642

PECOS Enrollment IDI20231013001688

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

120 services83 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

75 services75 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

49 services35 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

29 services28 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

23 services23 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St. Agnes Hospital Hospice

Acute Care Hospitals · Fond Du Lac, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520088

Location430 E Division StFond Du Lac, WI 54935 · Fond Du Lac County

Emergency services Birthing friendly

Waupun Memorial Hospital

Critical Access Hospitals · Waupun, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521327

Location620 W Brown StWaupun, WI 53963 · Fond Du Lac County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54935 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY R KELM NP

Nurse Practitioner