DANA BETH GRUENENFELDER NP
NPI 1245909969
Nurse Practitioner - Pediatrics in Middleton, WI


Quality Rating: 94.01 out of 100 score

NPI Status: Active since September 07, 2021

Contact Information

2275 DEMING WAY
MIDDLETON, WI
ZIP 53562
Phone: (608) 915-0480
Fax: (608) 833-3227

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  • Individual
  • Female
  • Years of Experience 5
  • Nurse Practitioner
  • Pediatrics
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About DANA GRUENENFELDER

This page provides the complete NPI Profile along with additional information for Dana Gruenenfelder, a provider established in Middleton, Wisconsin with a medical specialization in Nurse Practitioner, focusing in pediatrics and more than 5 years of experience. The healthcare provider is registered in the NPI registry with number 1245909969 assigned on September 2021. The practitioner's primary taxonomy code is 363LP0200X with license number 11371-33 (WI). The provider is registered as an individual and her NPI record was last updated June 2025.

NPI
1245909969
Provider Name
DANA BETH GRUENENFELDER NP
Gender
Female
Entity Type
Individual
Location Address
2275 DEMING WAY MIDDLETON, WI 53562
Location Phone
(608) 915-0480
Location Fax
(608) 833-3227
Mailing Address
7974 UW HEALTH CT MIDDLETON, WI 53562
Medical School Name
OTHER
Graduation Year
2021
Is Sole Proprietor?
No
Enumeration Date
09-07-2021
Last Update Date
06-30-2025
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A nurse practitioner (NP) like Dana Gruenenfelder is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

Secondary Locations

  • 731 Clay St
    Darlington, WI 53530
    (608) 776-2444
  • 107 Center St
    Argyle, WI 53504
    (608) 543-3392
  • 104 S Judgement St
    Shullsburg, WI 53586
    (608) 965-4475

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner Pediatrics

Taxonomy Code
363LP0200X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
11371-33
License State
WI

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

11317 (WI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Dean Bronze $0 Copay PCP Visits - HMO
  • Dean Bronze Share - HMO
  • Dean Catastrophic - HMO
  • Dean Expanded Bronze Standard - HMO
  • Dean Gold HSA - HMO
  • Dean Gold Share - HMO
  • Dean Gold Standard - HMO
  • Dean Silver $0 Copay PCP Visits - HMO
  • Dean Silver Share - HMO
  • Dean Silver Standard - HMO
  • Partners HMO Bronze 5000 Ded/9200 MOOP - HMO
  • Partners HMO Bronze 7500 Ded/9200 MOOP - HMO
  • Partners HMO Bronze 7900 Ded/7900 MOOP HSA - HMO
  • Partners HMO Gold 1000 Ded/6000 MOOP with Vision - HMO
  • Partners HMO Gold 1500 Ded/7800 MOOP - HMO
  • Partners HMO Gold 2900 Ded/2900 MOOP HSA - HMO
  • Partners HMO Silver 4100 Ded/7500 MOOP with Vision - HMO
  • Partners HMO Silver 5000 Ded/8000 MOOP - HMO
  • Partners HMO Silver 5500 Ded/5500 MOOP HSA - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $7250 HSA - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $9200 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $2500 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $2500 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $500 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $500 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER $0 DED FLAT RX COPAYS - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER $7000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $0 DED FLAT RX COPAYS - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $7000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
  • QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) $9100 DED FLAT RX COPAYS - IL - HMO
  • QUARTZ ONE ACHIEVE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - IL - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Dana Gruenenfelder is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Dana Gruenenfelder is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3173912458

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20211106000086

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.73 for a new patient copayment and $23.85 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 53562 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.41
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $23.85
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 94.01, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 94.01 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 92.95

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Dana Gruenenfelder is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MEMORIAL HOSPITAL OF LAFAYETTE COUNTY800 CLAY ST
DARLINGTON, WI 53530
(608) 776-4466Critical Access Hospitals

Reviews for DANA BETH GRUENENFELDER NP

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1245909969
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
228518018912
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 8 + 5 + 1 + 8 + 0 + 1 + 8 + 9 + 1 + 2 + 24 = 71
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 71 = 99

The NPI number 1245909969 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104835727DR. VIREN S BAVISHI DO
Individual
Pediatrics2275 DEMING WAY SUITE 220
MIDDLETON, WI 53562
(608) 417-8388
1982702676 JOSEPH P SPURGEON MD
Individual
Family Medicine2275 DEMING WAY SUITE 220
MIDDLETON, WI 53562
(608) 417-8388
1982890349MADISON VEIN AND LASER INSTITIUTE, S.C.
Organization
Clinic/Center (Medical Specialty)2275 DEMING WAY SUITE 280
MIDDLETON, WI 53562
(608) 831-7003
1902071301 KIM YUNG SOOK THOMPSON DO
Individual
Family Medicine2275 DEMING WAY SUITE 240
MIDDLETON, WI 53562
(608) 662-7762
1598911232 KIMBERLY K SCHUCHARDT PA
Individual
Physician Assistant (Medical)2275 DEMING WAY SUITE 240
MIDDLETON, WI 53562
(608) 662-7762
1972753283DR. SEYED HOSSEINI DDS
Individual
Dentist (General Practice)2275 DEMING WAY #180
MIDDLETON, WI 53562
(608) 827-6453
1588814891DR. CHRISTIAN S. KAMMER DDS
Individual
Dentist (General Practice)2275 DEMING WAY #180
MIDDLETON, WI 53562
(608) 827-6453
1174805022 CHRISTY STAATS APNP
Individual
Nurse Practitioner2275 DEMING WAY SUITE 220
MIDDLETON, WI 53562
(608) 417-8388
1124083779 TAMERA BERGET PA-C
Individual
Physician Assistant (Surgical)2275 DEMING WAY
MIDDLETON, WI 53562
(608) 417-8388
1992193924 AMANDA HANSEN
Individual
Specialist/Technologist (Athletic Trainer)2275 DEMING WAY
MIDDLETON, WI 53562
(608) 417-8366
1184967382 ANDREA H. HEWITT NP
Individual
Nurse Practitioner2275 DEMING WAY
MIDDLETON, WI 53562
(608) 417-8388
1457691396MR. EDWARD JAMES RATAJ LMFT
Individual
Marriage & Family Therapist2275 DEMING WAY
MIDDLETON, WI 53562
(608) 282-8200
1699846485CENTER FOR COSMETIC DENTISTRY
Organization
Dentist (General Practice)2275 DEMING WAY SUITE 180
MIDDLETON, WI 53562
(608) 827-6453
1447481056 AMBER B REYNOLDS PA-C
Individual
Physician Assistant2275 DEMING WAY
MIDDLETON, WI 53562
(608) 821-4020
1033291869 KRISTYN J HARE PA-C
Individual
Physician Assistant2275 DEMING WAY
MIDDLETON, WI 53562
(608) 417-8500
1356065171 KARISSA A HARENDA APSW
Individual
Social Worker2275 DEMING WAY
MIDDLETON, WI 53562
(608) 282-8200
1134837461 SYDNEY JUDITH ZETTLER LCSW
Individual
Social Worker (Clinical)2275 DEMING WAY
MIDDLETON, WI 53562
(608) 282-8200
1710023130DR. JOELLEN MARIE KOZLOWSKI PH.D.
Individual
Psychologist2275 DEMING WAY
MIDDLETON, WI 53562
(608) 282-8200
1780467852 EMILIE PINKOVITZ LCSW
Individual
Social Worker (Clinical)2275 DEMING WAY
MIDDLETON, WI 53562
(608) 282-8200
1922720911 SHAY JENS
Individual
Counselor (Mental Health)2275 DEMING WAY
MIDDLETON, WI 53562
(608) 333-1837

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1245909969, enumerated in the NPI registry as an "individual" on September 07, 2021

The provider is located at 2275 Deming Way Middleton, Wi 53562 and the phone number is (608) 915-0480

The provider's speciality is Nurse Practitioner with taxonomy code 363LP0200X with a focus in Pediatrics

The provider has more than 5 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Dean Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $95.41 and an average copayment of 23.85. Please review your insurance plan or contact the provider directly to determine your specific costs.

The practitioner is affiliated to the following hospital(s): MEMORIAL HOSPITAL OF LAFAYETTE COUNTY. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on September 07, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.