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(INACTIVE) MARSHFIELD MEDICAL CENTER - BEAVER DAM WAUPUN CENTER (HOPD
NPI 1629374780
Family Medicine in Waupun, WI

Active since February 07, 2011
180 GATEWAY DR, WAUPUN, WI 53963(920) 345-1306(920) 345-1325 Get Directions Write a Review

NPPES record last updated: March 3, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 3, 2022, May 13, 2019, Aug 20, 2018 (3 updates tracked since 2018).

About (inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd NPPES

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

(INACTIVE) MARSHFIELD MEDICAL CENTER - BEAVER DAM WAUPUN CENTER (HOPD (NPI 1629374780) is a healthcare organization registered as a family medicine in Waupun, Wisconsin and active in the NPI registry since February 2011. The organization lists Gordon T Edwards, Cfo/coo/ao, as its authorized official.

NPPES Registry Identity

NPI1629374780
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEAVER DAM COMMUNITY HOSPITALS INC
Location Address180 GATEWAY DRWaupun, WI 53963
Mailing Address1000 N Oak Ave, Attn: Provider Enrollment Services/wwpMarshfield, WI 54449-5703 · (715) 389-0660
Phone(920) 345-1306
Fax(920) 345-1325
Organization SubpartYesParent: Marshfield Clinic Health System Inc
Authorized OfficialGordon T EdwardsCfo/coo/ao · (715) 387-5823
Enumeration DateFebruary 7, 2011
Last NPPES UpdateMarch 3, 20223 updates tracked since enumeration
NPPES CertifiedMarch 3, 2022
✔ NPI 1629374780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
180 GATEWAY DR, Waupun, WI 53963
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Other Names 1

Doing Business As(inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

(inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

1,444

Medicare enrollment records show 1,444 clinicians reassign Medicare billing to (inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 65

Nurse Practitioner216
Certified Registered Nurse Anesthetist (CRNA)159
Emergency Medicine131
Physical Therapist in Private Practice107
Anesthesiology81
Hospitalist76
Obstetrics/Gynecology58
Family Practice52
57 other specialties564

Nearest to this location (20)

See all 1,444
Bert Callahan, MD
Orthopedic Surgery
NPI 1760573927
608 W BROWN ST
Waupun, WI 53963
(920) 324-6802
✔ PECOS✔ Accepts Medicare0.7 mi
Michael Jones, DO
Family Practice
NPI 1568533966
608 W BROWN ST
Waupun, WI 53963
(920) 324-6801
✔ PECOS0.7 mi
Thomas Castillo, DO
Ophthalmology
NPI 1700805454
240 CORPORATE DRIVE
Beaver Dam, WI 53916
(920) 887-1151
✔ PECOS12 mi
Charles Hendrix, OD
Optometry
NPI 1588747547
240 CORPORATE DRIVE
Beaver Dam, WI 53916
(920) 887-1151
✔ PECOS✔ Accepts Medicare12 mi
Benjamin Shier, DC
Chiropractic
NPI 1518989631
211 CORPORATE DR SUITE H
Beaver Dam, WI 53916
(920) 821-0071
✔ Accepts Medicare12 mi
Judy Macdonald, NP
Nurse Practitioner
NPI 1184933756
134 CORPORATE DR
Beaver Dam, WI 53916
(920) 356-1000
✔ PECOS✔ Accepts Medicare12 mi
Paul Larson, DPT
Physical Therapist in Private Practice
NPI 1336599224
803 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-4039
13 mi
Andrea Kvistad, OTR
Occupational Therapist in Private Practice
NPI 1518364496
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-4039
13 mi
Mesfin Abera, M.D.
Internal Medicine
NPI 1972852390
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-7181
✔ PECOS✔ Accepts Medicare13 mi
Shelby Brandsma, LCSW
Clinical Social Worker
NPI 1992458376
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 356-6558
✔ PECOS✔ Accepts Medicare13 mi
Christina Friedl, MD
Psychiatry
NPI 1649899709
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 821-0071
✔ PECOS✔ Accepts Medicare13 mi
Harinder Gill, M.D.
Interventional Cardiology
NPI 1437123049
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 356-6588
✔ PECOS✔ Accepts Medicare13 mi
Mary Schneider, MD
Anesthesiology
NPI 1942399480
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-7181
✔ PECOS✔ Accepts Medicare13 mi
Jason Schultz, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1336766971
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-7181
✔ PECOS13 mi
Laeekha Ali, MD
Pathology
NPI 1245200427
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-7181
✔ PECOS13 mi
Kyle Dennison, DPM
Podiatry
NPI 1467009233
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 219-4009
✔ PECOS✔ Accepts Medicare13 mi
Heidi Frederickson, SLP-CF
Qualified Speech Language Pathologist
NPI 1972288017
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-7181
13 mi
Kirsten Krohn, M.D.
Dermatology
NPI 1316365737
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-7181
✔ PECOS✔ Accepts Medicare13 mi
Nestor Machare Delgado, MD
Pulmonary Disease
NPI 1689868796
707 S UNIVERSITY AVE
Beaver Dam, WI 53916
(920) 887-6612
✔ PECOS✔ Accepts Medicare13 mi
Rula Al-Baghdadi, MD
Family Practice
NPI 1154819761
705 S UNIVERSITY AVE STE 400
Beaver Dam, WI 53916
(208) 887-5975
✔ PECOS13 mi
See all 1,444 clinicians

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 Beaver Dam Community Hospitals Inc's NPI number?

The NPI number for Beaver Dam Community Hospitals Inc is 1629374780. It was assigned to this organization in the NPPES registry on February 7, 2011. The provider is doing business as (inactive) Marshfield Medical Center - Beaver Dam Waupun Center (hopd.

Where is Beaver Dam Community Hospitals Inc located?

Beaver Dam Community Hospitals Inc is located at 180 Gateway Dr, Waupun, WI 53963. The listed phone number is (920) 345-1306.

What is Beaver Dam Community Hospitals Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Beaver Dam Community Hospitals Inc enrolled in Medicare?

Yes. Beaver Dam Community Hospitals Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Beaver Dam Community Hospitals Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1,444 clinicians in 65 Medicare specialties reassign their Medicare billing to Beaver Dam Community Hospitals Inc. 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. The largest specialties are Nurse Practitioner (216), Certified Registered Nurse Anesthetist (CRNA) (159) and Emergency Medicine (131). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Beaver Dam Community Hospitals Inc was last updated on March 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.