Individual provider Active NPI

Craig Jerome Schoenecker, MD

  • Psychiatry Physician
  • Watertown, WI
National Provider Identifier
1013920446
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
48195020 Issued in WI
Practice address
129 Hospital Dr
Watertown, WI 53098-3384
Phone
(920) 262-4800
Fax
(920) 262-4813
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 48195020 WI Primary

Addresses

Primary practice location

129 Hospital Dr
Watertown, WI 53098-3384

Mailing address

129 Hospital Dr
Watertown, WI 53098
Phone (920) 262-4800

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
I20061113000248 WI Practitioner - Psychiatry 1658379359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Wisconsin School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of SheboyganGroup PAC ID 2567568918, 6 clinicians
Washington County WisconsinGroup PAC ID 1951202142, 10 clinicians

Practice addresses (Care Compare)

1011 N 8TH St
Sheboygan, WI 53081-4006
Phone (920) 459-6403

333 E Washington St
Suite 2100
West Bend, WI 53095-2503
Phone (262) 335-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48195020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Wisconsin CurrentSince Sep 8, 2014 Accepting new patients
County of Sheboygan CurrentSince Feb 15, 2020 Accepting new patients

Locations

1011 N 8th St
Sheboygan, WI 53081
Phone (920) 459-6400

333 E Washington St
Ste 2100
West Bend, WI 53095
Phone (262) 335-4545

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013920446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "53098",
            "telephone_number": "920-262-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 HOSPITAL DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983384",
            "telephone_number": "920-262-4800",
            "fax_number": "920-262-4813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENECKER",
        "first_name": "CRAIG",
        "middle_name": "JEROME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "48195020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.