Individual provider Active NPI

Elizabeth E Ermatinger, MD

  • Pediatrics Physician
  • Appleton, WI
National Provider Identifier
1013410075
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
85836 Issued in WI
Practice address
2701 E Enterprise Ave
Appleton, WI 54913-7729
Phone
(920) 954-2551
Fax
(920) 954-2554
NPI assigned
Mar 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101268594 VA
Pediatrics Physician 208000000X 85836 WI Primary

Addresses

Primary practice location

2701 E Enterprise Ave
Appleton, WI 54913-7729

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 954-2551

Other practice location 1

301 Fisher St Ste F300
Keesler AFB, MS 39534-2508
Phone (228) 376-0402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250718001863 WI Practitioner - Pediatric Medicine 5698281566 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101268594VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Jul 20, 2025 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

2701 E Enterprise Ave
Appleton, WI 54913
Phone (920) 954-2551

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

640 Deerwood Ave
Neenah, WI 54956
Phone (920) 727-8622

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1013410075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-954-2551",
            "fax_number": "920-954-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 E ENTERPRISE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137729",
            "telephone_number": "920-954-2551",
            "fax_number": "920-954-2554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Fisher St Ste F300",
            "address_purpose": "LOCATION",
            "city": "Keesler AFB",
            "state": "MS",
            "postal_code": "395342508",
            "country_code": "US",
            "telephone_number": "228-376-0402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERMATINGER",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-15",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101268594",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "85836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.