NPIMap

Organization Active NPI

Ascension NE Wisconsin, Inc

  • Ambulatory Surgical Clinic/Center
  • Menasha, WI
National Provider Identifier
1124075536
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ASCENSION NE WISCONSIN, INC
Practice address
1550 Midway PL
Menasha, WI 54952
Phone
(920) 720-1464
Fax
(920) 720-1728
NPI assigned
May 30, 2006
Last updated
Jul 3, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
ASCENSION NE WISCONSIN, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Authorized official

Name
Susan Dwyer
Title
Cfo
Phone
(414) 465-3093

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary
General Acute Care Hospital 282N00000X 88 WI

Addresses

Primary practice location

1550 Midway PL
Menasha, WI 54952

Mailing address

1550 Midway PL
Menasha, WI 54952-1165
Phone (920) 720-1464

Other names 2

  • Ascension NE Wisconsin Surgery Center Other name
  • Ascension NE Wisconsin-St Elizabeth Surgery Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030627000014 WI Part A Provider - Hospital 7719897784 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Appleton, WI; Winneconne, WI; Neenah, WI; Menasha, WI; Greenville, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124075536. Details of each certification follow.

Hospital certification: CCN 520009

Legal name
ASCENSION NE WISCONSIN, INC
Doing business as
ASCENSION NE WISCONSIN-ST ELIZABETH CAMPUS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 1, 2003
Beds
332
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 3, 1930 in WI
Enrollment address
1506 S Oneida St
Appleton, WI 54915-1305
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Alcohol/drug

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Ascension NE Wisconsin - St Elizabeth CampusCCN 520009 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Part of
St Elizabeth Hospital I

Locations

1205 West American Dr
#220
Neenah, WI 54956

2700 W 9th Ave
Ste 215
Oshkosh, WI 54904

515 S Washburn St
Ste 104
Oshkosh, WI 54904
Phone (920) 236-8570

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ministry Health Care Inc Organization, Glendale, WI Non-profit Operational/Managerial Control Feb 8, 2012
Kurt Schley Individual Corporate DirectorBoard Member Jan 1, 2026
Michael Bergmann Individual W-2 Managing EmployeeHospital President Jan 25, 2021
Operational/Managerial ControlHospital President Jan 25, 2021
John Rowe Individual Corporate DirectorBoard Member Jul 1, 2018
Kristin a McManmon Individual Corporate DirectorBoard Member Jan 1, 2026
Daniel W Jackson Individual Corporate OfficerCeo Jan 1, 2024
W-2 Managing EmployeeCeo Jan 1, 2024
Operational/Managerial ControlCeo Jan 1, 2024
Robin Barten Individual W-2 Managing EmployeeNet Rev MGMT-MGR Nov 1, 2024
Michael McCullough Individual Corporate OfficerCfo Oct 21, 2024
W-2 Managing EmployeeCfo Oct 21, 2024
Operational/Managerial ControlCfo Oct 21, 2024
Stephanie Hietpas Individual W-2 Managing EmployeeNet Rev MGMT-MGR Nov 1, 2024
Andre I Storey Individual Corporate DirectorBoard Member Jan 1, 2026
Rexanne R Braun Individual W-2 Managing EmployeeEnrollment Coordinator Jul 1, 2019
David E Miller Individual Corporate DirectorBoard Member Jul 1, 2024
Ascension Health Organization, Saint Louis, MO Corporation, Non-profit Operational/Managerial Control Mar 1, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 510

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 510

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783036800000",
    "number": "1124075536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 MIDWAY PL",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521165",
            "telephone_number": "920-720-1464",
            "fax_number": "920-720-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 MIDWAY PL",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "54952",
            "telephone_number": "920-720-1464",
            "fax_number": "920-720-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION NE WISCONSIN, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASCENSION NE WISCONSIN, INC",
        "enumeration_date": "2006-05-30",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "414-465-3093"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WI",
            "license": "88",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension NE Wisconsin Surgery Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ascension NE Wisconsin Surgery Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ascension NE Wisconsin-St Elizabeth Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.