Andrew John Vanbruggen, DO

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

77450 Issued in WI

Practice address

2654 S Oneida St Stop 102
Green Bay, WI 54304-5337

Phone

(888) 938-3838

Fax

(888) 919-1083

NPI assigned

Jun 30, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Otolaryngology

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear Institutes LLCGroup PAC ID 4880928761, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ear Institutes, LLC

  • Otolaryngology Physician
  • Blaine, MN
  • NPI 1881168441
  Medicare reassignment Care Compare group NPD
• Advanced Ear Nose & Throat Specialists, SC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Milwaukee, WI
  • NPI 1689782427
  Medicare reassignment NPD
• Advanced Ear Nose & Throat Specialists, SC

  • Otolaryngology Physician
  • Miamisburg, OH
  • NPI 1811717887
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1003337809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2654 S ONEIDA ST STOP 102",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045337",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1031 McIntosh Cir",
            "address_purpose": "LOCATION",
            "city": "Joplin",
            "state": "MO",
            "postal_code": "648043643",
            "country_code": "US",
            "telephone_number": "417-347-5665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "247 S Nicolet Rd",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549143938",
            "country_code": "US",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4365 Pheasant Ridge Dr NE Ste 106",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554494544",
            "country_code": "US",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBRUGGEN",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2017018862",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "69733",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "77450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Van Sistine
• Brooke Elizabeth Van Zeeland, NP
• Katie Vanasten
• Edward Patrick Vanbeek, DPM
• Jalyssa Vanboxel, MSW, LCSW
• Kimberly A Vande Hey, NP
• Nancy Vande Hey
• Mark Robert Vande Walle, DDS
• Danielle M Vandeberg, PA
• Gail M Vandecastle

• Otolaryngology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Otolaryngology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.