Active NPI
Orthopedic Surgery Center of the Fox Valley LLC
- Ambulatory Surgical Clinic/Center
- Neenah, WI
National Provider Identifier
1164056974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC
- Practice address
- 1205 W American Dr
Neenah, WI 54956-1405 - Phone
- (920) 965-6382
- NPI assigned
- Mar 2, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandy Fragale
- Title
- Board Chair
- Phone
- (920) 965-9520
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
1205 W American Dr
Neenah, WI 54956-1405
Mailing address
2223 Lime Kiln Rd Ste 1
Green Bay, WI 54311-6213
Phone (920) 965-6382
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200526000233 | WI | Part B Supplier - Ambulatory Surgical Center | 5597186775 | Practice locations: Neenah, WI |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Orthopedic Surgery Center of the Fox Valley LLC
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2192975 | Orthopedic Surgery Center of the Fox Valley, LLC | Certificate of waiver | Sep 15, 2026 |
National Provider Directory
National Provider DirectoryLocations
1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Green Bay, WI
- NPI 1043269806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737504000000",
"number": "1164056974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2223 LIME KILN RD STE 1",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543116213",
"telephone_number": "920-965-6382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 W AMERICAN DR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549561405",
"telephone_number": "920-965-6382"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORTHOPEDIC SURGERY CENTER OF THE FOX VALLEY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-03-02",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A",
"authorized_official_last_name": "FRAGALE",
"authorized_official_first_name": "SANDY",
"authorized_official_title_or_position": "BOARD CHAIR",
"authorized_official_telephone_number": "920-965-9520"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.