1. Home
  2. Directory
  3. Wisconsin
  4. Altoona
  5. Specialist
  6. NPI Profile

DEFATTA ENT & FACIAL PLASTIC SURGERY SC
NPI 1346664059
Specialist in Altoona, WI

Active since February 17, 2014
1490 RIVERS EDGE TRAIL, ALTOONA, WI 54720(715) 828-2368(715) 726-2087 Get Directions Write a Review

NPPES record last updated: May 5, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Defatta Ent & Facial Plastic Surgery Sc NPPES

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

DEFATTA ENT & FACIAL PLASTIC SURGERY SC (NPI 1346664059) is a healthcare organization registered as a specialist in Altoona, Wisconsin and active in the NPI registry since February 2014. The organization lists Robert Joseph Defatta, Owner, as its authorized official.

NPPES Registry Identity

NPI1346664059
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameDEFATTA ENT & FACIAL PLASTIC SURGERY SC
Location Address1490 RIVERS EDGE TRAILAltoona, WI 54720-1495
Mailing Address1490 Rivers Edge TrailAltoona, WI 54720-1495 · (715) 828-2368 · Fax (715) 726-2087
Phone(715) 828-2368
Fax(715) 726-2087
Organization SubpartNo
Authorized OfficialRobert Joseph DefattaOwner · (715) 828-2368
Enumeration DateFebruary 17, 2014
Last NPPES UpdateMay 5, 2014
✔ NPI 1346664059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in WI · 55984-20
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X · License 55984-20 (WI)
1490 RIVERS EDGE TRAIL, Altoona, WI 54720
Open in Google Maps ↗

Other Identifiers 3

Other1790931707WI · Npi Provider
Other1578697520WI · Npi
Medicaid100016459WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Dean Health Plan, Quartz and more.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)

Defatta Ent & Facial Plastic Surgery Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Defatta Ent & Facial Plastic Surgery Sc, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Rima Defatta, M.D.
Otolaryngology
NPI 1790931707
1490 RIVERS EDGE TRL
Altoona, WI 54720
(715) 828-2368
✔ PECOS✔ Accepts MedicareSame address
Robert Defatta, MD, PH D, FACS
Otolaryngology
NPI 1578697520
1490 RIVERS EDGE TRAIL
Altoona, WI 54720
(715) 828-2368
✔ PECOS✔ Accepts MedicareSame address
Kirsten Kern, NP
Nurse Practitioner
NPI 1174082630
1490 RIVERS EDGE TRL
Altoona, WI 54720
(715) 828-2368
✔ PECOS✔ Accepts MedicareSame address
Nancy Huebler, AUD CCCA
Qualified Audiologist
NPI 1003924317
2655 CTY HWY I
Chippewa Fls, WI 54729
(715) 726-4193
✔ Accepts Medicare12 mi
Timothy Lippold, AU.D.
Qualified Audiologist
NPI 1538370440
2821 8TH ST S
Wisconsin Rapids, WI 54494
(715) 423-4327
86 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 Defatta Ent & Facial Plastic Surgery Sc's NPI number?

The NPI number for Defatta Ent & Facial Plastic Surgery Sc is 1346664059. It was assigned to this organization in the NPPES registry on February 17, 2014.

Where is Defatta Ent & Facial Plastic Surgery Sc located?

Defatta Ent & Facial Plastic Surgery Sc is located at 1490 Rivers Edge Trail, Altoona, WI 54720. The listed phone number is (715) 828-2368.

What is Defatta Ent & Facial Plastic Surgery Sc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Defatta Ent & Facial Plastic Surgery Sc enrolled in Medicare?

Yes. Defatta Ent & Facial Plastic Surgery Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Defatta Ent & Facial Plastic Surgery Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Defatta Ent & Facial Plastic Surgery Sc, in Nurse Practitioner, Otolaryngology and Qualified Audiologist. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Defatta Ent & Facial Plastic Surgery Sc accept?

Health plans from Anthem Blue Cross and Blue Shield, Dean Health Plan, Quartz and Security Health Plan list Defatta Ent & Facial Plastic Surgery 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 Defatta Ent & Facial Plastic Surgery Sc was last updated on May 5, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.