Individual provider Active NPI

Herbert J Wiser, MD

  • Urology Physician
  • De Pere, WI
National Provider Identifier
1053573147
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
65930-20 Issued in WI
Practice address
1385 W Main Ave
De Pere, WI 54115-9366
Phone
(920) 433-9400
Fax
(920) 455-9409
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 154907 AK
Urology Physician 208800000X 036132577 IL
Urology Physician 208800000X 65930-20 WI Primary

Addresses

Primary practice location

1385 W Main Ave
De Pere, WI 54115-9366

Mailing address

1385 W Main Ave
De Pere, WI 54115-9366
Phone (920) 433-9400

Other practice location 1

2720 Cahill Rd
Marinette, WI 54143-3892
Phone (920) 433-9400

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
I20160812000041 WI Practitioner - Urology 2567606890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Urology Associates of Green Bay SCGroup PAC ID 1658350616, 12 clinicians

Practice addresses (Care Compare)

1385 W Main Ave
De Pere, WI 54115-9366
Phone (920) 433-9400

1580 Commanche Ave
Green Bay, WI 54313-5751
Phone (920) 433-9400

2720 Cahill Rd
Marinette, WI 54143-3892
Phone (920) 433-9400

720 S Van Buren St
Suite 301
Green Bay, WI 54301-3534

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 433-9400

Hospital & facility affiliations

  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
  • Bellin Health Oconto Hospital Hospital, Oconto, WI, CCN 521356

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Associates of Green Bay, S.C. CurrentSince Jul 31, 2023 Accepting new patients
Urology Associates of Green Bay, SC Past Accepting new patients

Locations

1385 W Main Ave
De Pere, WI 54115

720 S Van Buren St
Ste 301
Green Bay, WI 54301
Phone (920) 433-9000

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

720 S Van Buren St
Green Bay, WI 54301
Phone (920) 430-7100

2720 Cahill Rd
Marinette, WI 54143
Phone (715) 732-3420

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1053573147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 W MAIN AVE",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159366",
            "telephone_number": "920-433-9400",
            "fax_number": "920-455-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 W MAIN AVE",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159366",
            "telephone_number": "920-433-9400",
            "fax_number": "920-455-9409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 Cahill Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433892",
            "country_code": "US",
            "telephone_number": "920-433-9400",
            "fax_number": "920-455-9409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISER",
        "first_name": "HERBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AK",
            "license": "154907",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036132577",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "65930-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.