Etienne A. Mejia, M.D.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

41224 Issued in WI

Practice address

277 Altenhofen Dr
Appleton, WI 54913-8401

Phone

(920) 993-1643

Fax

(920) 993-1645

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Orthopedic Surgery

Education

Tulane University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Medicine Center S CGroup PAC ID 0648265801, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDAACA/Endpoint/IDAACA
• Direct secure messaging: etienne.mejia.1@17649.direct.athenahealth.com

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.

• Sports Medicine Center S C

  • Orthopaedic Surgery Physician
  • Appleton, WI
  • NPI 1093729055
  Medicare reassignment Care Compare group NPD Authorized official

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

• Thedacare Regional Medical Center - Appleton, Inc

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1740920909
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1497119218
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1689038408
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1831773589
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1902832306
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1912721002
  Care Compare affiliation
• Thedacare Regional Medical Center - Appleton, Inc.

  • General Acute Care Hospital
  • Oshkosh, WI
  • NPI 1912880329
  Care Compare affiliation

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1184648131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 ALTENHOFEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138401",
            "telephone_number": "920-993-1643",
            "fax_number": "920-993-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 ALTENHOFEN DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138401",
            "telephone_number": "920-993-1643",
            "fax_number": "920-993-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "ETIENNE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "41224",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WI",
            "license": "41224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "391821816017",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Medova Mobility LLC
• Brenton M Meier, M.D.
• Yen Sun Meier
• Morgan Leigh Meiners, CSAC
• Megan Meives
• Sue A.W. Melcher, PSY.D.
• Elizabeth Christine Melchert, O.D.
• Daniel Richard Meldrum, MD
• Gary A Melis, RPH
• Brenda Melnarik, APNP, BC, FNP, RN

• Sports Medicine (Orthopaedic Surgery) Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.