ANGELA DAWN DIVJAK MD
NPI 1639343973
Family Medicine in Shawano, WI

NPI Status: Active since April 17, 2008

Contact Information

100 COUNTY ROAD B
SHAWANO, WI
ZIP 54166
Phone: (715) 524-2161

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  • Individual
  • Female
  • Years of Experience 18
  • Family Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ANGELA DIVJAK

This page provides the complete NPI Profile along with additional information for Angela Divjak, a primary care provider established in Shawano, Wisconsin with a medical specialization in Family Medicine and more than 18 years of experience. She graduated from University Of Wisconsin School Of Medicine in 2008. The healthcare provider is registered in the NPI registry with number 1639343973 assigned on April 2008. The practitioner's primary taxonomy code is 207Q00000X with license number 57265-20 (WI). The provider is registered as an individual and her NPI record was last updated 13 years ago.

NPI
1639343973
Provider Name
ANGELA DAWN DIVJAK MD
Gender
Female
Entity Type
Individual
Location Address
100 COUNTY ROAD B SHAWANO, WI 54166
Location Phone
(715) 524-2161
Mailing Address
PO BOX 8003 APPLETON, WI 54912
Medical School Name
UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduation Year
2008
Is Sole Proprietor?
No
Enumeration Date
04-17-2008
Last Update Date
07-16-2012
Code Navigator

A primary care provider (PCP) like Angela Divjak sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
57265-20
License State
WI
Taxonomy Description
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.

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)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

2008026576 (MO)

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 Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Priority/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • 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 Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • HMO Bronze $0 Medical Deductible - HMO
  • HMO Bronze 7500 - HMO
  • HMO Catstrophic 9200 with 3 Free PCP Visits - HMO
  • HMO Gold 1500 - HMO
  • HMO Gold 2400 - HMO
  • HMO HDHP Bronze 7200 - HMO
  • HMO HDHP Silver 5400 - HMO
  • HMO Silver 5000 - HMO
  • HMO Silver 6600 - HMO
  • POS Bronze 7500 - POS
  • CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network - EPO
  • CGHC Bronze $0 Ded / $2250 Rx Ded - Envision Network (Vision Exam) - EPO
  • CGHC Bronze $9200 ($40 PCP Copay) - Envision Network - EPO
  • CGHC Bronze $9200 ($40 PCP Copay) - Envision Network (Vision Exam) - EPO
  • CGHC Bronze Standard $7500 - Envision Network - EPO
  • CGHC Bronze Standard $7500 - Envision Network (Vision Exam) - EPO
  • CGHC Catastrophic $9200 - Envision Network - EPO
  • CGHC Gold $0 Ded - Envision Network - EPO
  • CGHC Gold $0 Ded - Envision Network (Vision Exam) - EPO
  • CGHC Gold $3000 - Envision Network - EPO
  • Robin Oak $1,000 Gold - PPO
  • Robin Oak $1,500 Standard Gold - PPO
  • Robin Select $2,800 Plus Silver - PPO
  • Robin Select $3,500 HSA Silver - PPO
  • Robin Select $5,000 Standard Silver - PPO
  • Robin Select $6,500 Plus Bronze - PPO
  • Robin Select $7,500 Standard Bronze - PPO
  • Robin Select $8,200 HSA Bronze - PPO
  • Robin Select $9,200 Catastrophic - PPO
  • 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
  • Premier $1,500 - 25% - HMO
  • Premier $3,500 - 30% - HMO
  • Premier $4,100 HDHP - HMO
  • Premier $5,000 - 40% - HMO
  • Premier $6,200 HDHP - HMO
  • Premier $7,500 - HMO
  • Premier $9,200 - HMO
  • Premier Protection - HMO
  • Premier HMO $1,500 - 30% - HMO
  • Premier HMO $2,500 - 20% Copay - HMO

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

Medicare Participation & PECOS Enrollment Status

Angela Divjak 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.

Angela Divjak 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: 5991973976

    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: I20120829000361

    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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • DME-Other DME (DE017N)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    3 DME suppliers used 14 Medicare Claims 39 Services Paid

  • DME-Hospital Beds (DB000N)

    Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)

    2 DME suppliers used 15 Medicare Claims 15 Services Paid

  • DME-Other DME (DE000N)

    Nebulizer, with compressor (HCPCS:E0570)

    2 DME suppliers used 18 Medicare Claims 18 Services Paid

  • DME-Oxygen and Supplies (DC002N)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 22 Medicare Claims 22 Services Paid

  • DME-Other DME (DE017N)

    Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service (HCPCS:K0553)

    3 DME suppliers used 25 Medicare Claims 25 Services Paid

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 54166 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.

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. Angela Divjak is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
THEDACARE REGIONAL MED CTR - NEENAH130 2ND ST
NEENAH, WI 54956
(920) 729-3100Acute Care Hospitals
THEDACARE MEDICAL CENTER - SHAWANO100 COUNTY RD B
SHAWANO, WI 54166
(715) 526-2111Critical Access Hospitals

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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.
1639343973
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2669646914
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 6 + 9 + 6 + 4 + 6 + 9 + 1 + 4 + 24 = 77
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 77 = 33

The NPI number 1639343973 is valid because the calculated check digit 3 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
1497745715 ANN M TOUSIGNANT MD
Individual
Obstetrics & Gynecology100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1114907011 JEFFREY LEE MINIKEL MD
Individual
Orthopaedic Surgery100 COUNTY ROAD B
SHAWANO, WI 54166
(920) 831-5050
1689622979 THOMAS L OLMSTED CRNA
Individual
Nurse Anesthetist, Certified Registered100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1386689008 KATHLEEN QUALHEIM MD
Individual
Family Medicine100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1124054150 GREGORY THATCHER MD
Individual
Family Medicine100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1316972607 SUSAN GRUETZMACHER NP
Individual
Physician Assistant (Medical)100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1891705364 JOHN D SCHARINE CRNA
Individual
Nurse Anesthetist, Certified Registered100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1467462838 JOHN E SCHREINER CRNA
Individual
Nurse Anesthetist, Certified Registered100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1013044833DR. MINDY MARIA FRIMODIG DO
Individual
Family Medicine100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1720117575DR. MICHAEL E WEST MD
Individual
Obstetrics & Gynecology100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1124221403DR. JOHN EDWARD LAABS M.D.
Individual
Family Medicine100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1750510103 JILL OLSEN APNP
Individual
Nurse Practitioner100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1912163155 CHERYLE L RICHTER
Individual
Pharmacist100 COUNTY ROAD B
SHAWANO, WI 54166
(815) 762-0609
1306182118 JASON J KRUEGER APNP
Individual
Nurse Practitioner100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1467892075 LENORE K WESPETAL CD
Individual
Dietitian, Registered100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1023458262 WILL GILLIS PHARMD
Individual
Pharmacist100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 526-3456
1649611930 DIANA J SCHARINE APNP
Individual
Nurse Practitioner100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1295160612 MARGARET L PIEPER CD
Individual
Dietitian, Registered100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161
1275594491DR. CLAY A CANADAY DO
Individual
Orthopaedic Surgery100 COUNTY ROAD B
SHAWANO, WI 54166
(920) 831-5050
1063430387 ANNA G GILBERTSON MD
Individual
Surgery100 COUNTY ROAD B
SHAWANO, WI 54166
(715) 524-2161

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639343973, enumerated in the NPI registry as an "individual" on April 17, 2008

The provider is located at 100 County Road B Shawano, Wi 54166 and the phone number is (715) 524-2161

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 18 years of experience. She graduated from University Of Wisconsin School Of Medicine in 2008.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus 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.

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): THEDACARE REGIONAL MED CTR - NEENAH and THEDACARE MEDICAL CENTER - SHAWANO. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 17, 2008. 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.