Community Pediatrics Sc

Community Pediatrics Sc is a healthcare organization registered as Pediatrics Physician in Beaver Dam, WI, holding Type 2 (organization) NPI 1275749566 since 2007. The authorized official on file is Dorothy Larson, Account Manager.

✓ Active NPI ✓ Valid NPI checksum

NPI	1275749566
Entity type	Organization (Type 2)
Legal business name	Community Pediatrics Sc
Practice address	109 WARREN ST STE 4, Beaver Dam, WI, 53916
Phone	9208853305
Fax	9208855506
Enumeration date	2007-05-15
Last updated in NPPES	2010-04-08

Authorized official

Name	Dorothy Larson
Title	Account Manager
Phone	9208853305

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
363LP0200X	Pediatric Nurse Practitioner	Secondary	—	—
208000000X	Pediatrics Physician	Primary	—	—

Other identifiers

Identifier	Type	State	Issuer
34638800	Medicaid	WI	—

Copy-ready billing details

Provider: Community Pediatrics Sc
NPI: 1275749566
Taxonomy: 208000000X (Pediatrics Physician)
Address: 109 WARREN ST STE 4, Beaver Dam, WI, 53916

Providers at this address

NPI	Name	Type	Specialty	Location
1437354602	Jay Miesfeld	Individual	Pediatrics Physician	Beaver Dam, WI
1710272778	Kaitlyn Pufahl	Individual	Pediatric Nurse Practitioner	Beaver Dam, WI
1154828226	Misty Romero Rivera	Individual	Pediatric Nurse Practitioner	Beaver Dam, WI

Verify this record

Cross-check NPI 1275749566 against the authoritative CMS record: view Community Pediatrics Sc on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Community Pediatrics Sc located?

The practice location on file with NPPES is in Beaver Dam, WI.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2010-04-08. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2010-04-08.