NPIMap

Organization Active NPI

Bellin Memorial Hospital Inc

Doing business as Bellin Health Surgical Associates

  • Surgery Physician
  • Green Bay, WI
National Provider Identifier
1104263532
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
BELLIN MEMORIAL HOSPITAL INC
Doing business as
Bellin Health Surgical Associates
Practice address
720 S Vanburen St
Suite 201
Green Bay, WI 54301-3534
Phone
(920) 433-7488
Fax
(920) 433-7439
NPI assigned
May 24, 2013
Last updated
Feb 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Denise K Stroobants
Title
Credentialing Specialist
Phone
(920) 445-7226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

720 S Vanburen St
Suite 201
Green Bay, WI 54301-3534

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other names 1

  • Bellin Health Surgical Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000089 WI Part B Supplier - Clinic/Group Practice 8820900749 Receives reassigned benefits from 936 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Peshtigo Family Prac55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Locations

2714 Riverview Dr
Green Bay, WI 54313
Phone (920) 430-4760

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1104263532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S VANBUREN ST",
            "address_2": "SUITE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013534",
            "telephone_number": "920-433-7488",
            "fax_number": "920-433-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLIN MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-24",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "STROOBANTS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "920-445-7226"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellin Health Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bellin Health Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.