NPIMap

Individual provider Active NPI

Stephen J Serio, M.D.

  • Surgery Physician
  • Green Bay, WI
National Provider Identifier
1245525989
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
70849-20 Issued in WI
Practice address
1821 S Webster Ave
Green Bay, WI 54301-2253
Phone
(920) 496-4700
NPI assigned
Jun 10, 2011
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 7365 NE
Surgery Physician 208600000X 70849-20 WI Primary
Surgery Physician 208600000X 4301098449 MI

Addresses

Primary practice location

1821 S Webster Ave
Green Bay, WI 54301-2253

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other identifiers 1

IdentifierTypeStateIssuer
100089545MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sserio247684@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190729000343 WI Practitioner - Vascular Surgery 8224302401 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Rush Medical College of Rush University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1821 S Webster Ave
Green Bay, WI 54301-2253
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal14
Leg revascularization (restoring blood flow)56
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7365NEMDClinical Social Worker
4301098449MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 1, 2019 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Surgery CurrentSince Jul 1, 2019 Accepting new patients
St. Clare Memorial Hospital, Inc Surgery CurrentSince Jul 1, 2019 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2019 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Jul 1, 2019 Accepting new patients

Locations

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

1860 Shawano Ave
Green Bay, WI 54303
Phone (920) 405-1414

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: sserio247684@ewd.direct.hshs.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1245525989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012253",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERIO",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "7365",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "70849-20",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301098449",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089545",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sserio247684@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1821 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543012253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.