ANGELA DAWN DIVJAK MD
NPI 1639343973
Family Medicine in Shawano, WI
About Angela Dawn Divjak Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANGELA DAWN DIVJAK MD (NPI 1639343973) is an individual family medicine provider in Shawano, Wisconsin, licensed in Wisconsin (57265-20) and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and is a graduate of University Of Wisconsin School Of Medicine (2008).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Angela Dawn Divjak Md 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.
Medicare Billing Reassignments
2Medicare enrollment records show Angela Divjak reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Shawano, WI 54166
- Reassigned Medicare billing, Wisconsin enrollment
- 70 clinicians in this Medicare group
New London, WI 54961
- Reassigned Medicare billing, Wisconsin enrollment
- 988 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Thedacare Regional Med Ctr - Neenah
Acute Care Hospitals · Neenah, WIThedacare Medical Center - Shawano
Critical Access Hospitals · Shawano, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 54166 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims 5
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
SHAWANO, WI 54166
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 Angela Divjak's NPI number?
The NPI number for Angela Divjak is 1639343973. It was assigned to this individual provider in the NPPES registry on April 17, 2008.
Where is Angela Divjak located?
Angela Divjak practices at 100 County Road B, Shawano, WI 54166. The listed phone number is (715) 524-2161.
What is Angela Divjak's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Angela Divjak enrolled in Medicare?
Yes. Angela Divjak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Angela Divjak's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Angela Divjak reassigns Medicare benefits to 2 organizations: Thedacare Medical Center - Shawano, Inc. (Shawano, WI) and Thedacare, Incorporated (New London, WI). Each 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 Angela Divjak's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Angela Divjak accept?
Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 1 other insurer list Angela Divjak 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.
Is Angela Divjak affiliated with any hospitals?
According to CMS data, Angela Divjak is affiliated with Thedacare Regional Med Ctr - Neenah and Thedacare Medical Center - Shawano.
When was this NPI record last updated?
The NPPES record for Angela Divjak was last updated on July 16, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Angela Dawn Divjak, MD · NPI 1639343973
Family Medicine physician in Shawano, Wisconsin. Individual provider, active in the CMS NPPES registry since April 17, 2008.
## Identity
- **NPI:** 1639343973 (Entity type: Individual)
- **Enumerated:** April 17, 2008
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 57265-20 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 100 COUNTY ROAD B, Shawano, WI 54166-7072
- **Phone:** (715) 524-2161
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Thedacare Medical Center - Shawano, Inc. (NPI 1548260839, Shawano, WI); Thedacare, Incorporated (NPI 1376656959, New London, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Wisconsin School Of Medicine, class of 2008
## Record status
- **NPPES last updated:** July 16, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1639343973) · Data from the CMS NPPES public registry.