Patrick James Brennan, M.D.
Individual provider Active NPI Surgery Physician · Neenah, WI
NPI 1104876945 · NPPES record last updated May 8, 2008
Key facts
- NPI
- 1104876945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 44570 (WI)
- Practice address
- 100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763 - Phone
- (920) 725-4527
- Fax
- (920) 725-0991
- NPI assigned
- May 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 18
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Wisconsin School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Surgical Associates of Neenah, S.C.
Practice addresses (Care Compare)
100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Phone (920) 725-4527
Hospital & facility affiliations
- Thedacare Regional Med Ctr - Neenah
- Thedacare Medical Center - Shawano
- Thedacare Medical Center - New London
- Thedacare Regional Medical Center - Appleton Inc
- Thedacare Medical Center - Berlin Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 44 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 46 |
| Varicose vein removal | 1-10 |
| Removal of tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120213000489 | WI | Practitioner - General Surgery |
7214194638 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44570 | WI | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Associates of Neenah, S.C. | Surgery | Current |
Accepting new patients |
Locations
130 2nd St
Neenah, WI 54956
Phone (920) 729-2063
100 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 722-7747
100 Theda Clark Medical Plz
Ste 400
Neenah, WI 54956
Phone (414) 725-4527
100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161
Interoperability endpoints
- pbrennan21071@direct.thedacare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 44570 | WI | Yes |
| Surgical Critical Care Physician | 2086S0102X | 44570 | WI | |
| Trauma Surgery Physician | 2086S0127X | 44570 | WI | |
| Vascular Surgery Physician | 2086S0129X | 44570 | WI | |
| Colon & Rectal Surgery Physician | 208C00000X | 44570 | WI |
Addresses
Primary practice location
100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Mailing address
100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Phone (920) 725-4527
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34211900 | Medicaid | WI |
Other providers in Neenah, WI
- Bouressa Dental Associates, S.C.
- Michael J Bouressa
- Kenneth L Branstetter
- Kelly Branstrom
- Breast Surgery Experts of Northeast Wisconsin, LLC
- Amy H. Brewster
- Lauran M Brice
- Alysha Brickl
- Bridgewood Nursing and Rehab Center LLC
- Brookdale Senior Living Communities, Inc.
All providers in Neenah, WI · Surgery Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.