COMMUNITY PEDIATRICS SC
NPI 1275749566
Pediatrics in Beaver Dam, WI

Q: What is Community Pediatrics Sc's NPI number?

The NPI number for Community Pediatrics Sc is 1275749566. It was assigned to this organization in the NPPES registry on May 15, 2007.

Q: What is Community Pediatrics Sc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since May 15, 2007

109 WARREN ST STE 4, BEAVER DAM, WI 53916(920) 885-3305(920) 885-5506 Get Directions Write a Review

NPPES record last updated: April 8, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Community Pediatrics Sc NPPES

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

COMMUNITY PEDIATRICS SC (NPI 1275749566) is a healthcare organization registered as a pediatrics in Beaver Dam, Wisconsin and active in the NPI registry since May 2007. The organization lists Dorothy Jean Larson, Account Manager, as its authorized official.

NPPES Registry Identity

NPI1275749566

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameCOMMUNITY PEDIATRICS SC

Location Address109 WARREN ST STE 4Beaver Dam, WI 53916-3082

Mailing Address109 Warren St Ste 4Beaver Dam, WI 53916-3082 · (920) 885-3305 · Fax (920) 885-5506

Phone(920) 885-3305

Fax(920) 885-5506

Organization SubpartNo

Authorized OfficialDorothy Jean LarsonAccount Manager · (920) 885-3305

Enumeration DateMay 15, 2007

Last NPPES UpdateApril 8, 2010

✔ NPI 1275749566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X

109 WARREN ST STE 4, Beaver Dam, WI 53916

Open in Google Maps ↗

Other Identifiers 2

Medicare UPINI34154WI

Medicaid34638800WI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Community Pediatrics Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Community Pediatrics Sc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jay Miesfeld, M.D.

Pediatric Medicine

NPI 1437354602

109 WARREN ST STE 4
Beaver Dam, WI 53916

(920) 885-3305

✔ PECOS0.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Community Pediatrics Sc's NPI number?

The NPI number for Community Pediatrics Sc is 1275749566. It was assigned to this organization in the NPPES registry on May 15, 2007.

Where is Community Pediatrics Sc located?

Community Pediatrics Sc is located at 109 Warren St Ste 4, Beaver Dam, WI 53916. The listed phone number is (920) 885-3305.

What is Community Pediatrics Sc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Community Pediatrics Sc enrolled in Medicare?

Yes. Community Pediatrics Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Community Pediatrics Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pediatric Medicine) reassigns their Medicare billing to Community Pediatrics Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Community Pediatrics Sc accept?

Health plans from Anthem Blue Cross and Blue Shield list Community Pediatrics Sc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Community Pediatrics Sc was last updated on April 8, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.