MARY J DALZELL NP
NPI 1942552658
Nurse Practitioner - Adult Health in Fond Du Lac, WI

Q: What is Mary Dalzell's NPI number?

The NPI number for Mary Dalzell is 1942552658. It was assigned to this individual provider in the NPPES registry on October 4, 2012.

Q: What is Mary Dalzell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Mary Dalzell was last updated on April 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.

Active since October 04, 2012PECOS EnrolledAccepts Medicare Assignment

420 E DIVISION ST, FOND DU LAC, WI 54935(920) 926-8230(920) 926-8997 Get Directions Write a Review

NPPES record last updated: April 23, 2025. Verified against the NPPES registry weekly; last sync: September 27, 2026.

On this page

About Mary J Dalzell Np NPPES

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

MARY J DALZELL NP (NPI 1942552658) is an individual adult health provider in Fond Du Lac, Wisconsin, licensed in Wisconsin (5008) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS, is affiliated with St. Agnes Hospital Hospice, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1942552658

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMARY J DALZELLCredential: NP

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

Mailing Address420 E Division StFond Du Lac, WI 54935-4560 · (920) 926-8230 · Fax (920) 926-8997

Phone(920) 926-8230

Fax(920) 926-8997

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateOctober 4, 2012

Last NPPES UpdateApril 23, 2025

NPPES CertifiedApril 23, 2025

✔ NPI 1942552658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in WI · 5008

Also ListedNurse PractitionerTaxonomy 363L00000X · License 5008 (WI)

420 E DIVISION ST, Fond Du Lac, WI 54935

Open in Google Maps ↗

Secondary Practice Locations 3

Location 19200 W Wisconsin Ave, DIVISION OF CARDIOLOGYMilwaukee, WI 53226-3522 · Phone (414) 955-6777 · Fax (414) 955-6203

Location 22009 5th StMonroe, WI 53566-1546 · Phone (608) 324-2000

Location 31211 Fish Hatchery RdMadison, WI 53715-1909 · Phone (608) 252-8000 · Fax (608) 410-2905

Other Identifiers 1

Medicaid1942552658WI

Accepted Insurance

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

Mary J Dalzell Np 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 ID7214180306

PECOS Enrollment IDI20130124000243

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 4

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 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.

171 services160 patients

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.

88 services72 patients

Remote monitoring of pulmonary artery pressure sensor, up to 30 days 93264

Remote monitoring of pulmonary artery pressure is a procedure where a sensor, placed in your lung artery, transmits data about your heart's function for up to 30 days. This helps doctors monitor your heart health remotely, ensuring timely intervention if needed.

66 services12 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

50 services40 patients

Hospital Affiliations CMS Care Compare

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

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