Active NPI
Richard L Erdman, M.D.
- Internal Medicine Physician
- Green Bay, WI
National Provider Identifier
1326090697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 24509
- Practice address
- 725 S Webster Ave
Green Bay, WI 54301-3500 - Phone
- (920) 433-3456
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 24509-020 | WI | |
| Internal Medicine Physician | 207R00000X | 24509 | WI | Primary |
Addresses
Primary practice location
725 S Webster Ave
Green Bay, WI 54301-3500
Mailing address
508 Randall Ave
De Pere, WI 54115-2638
Phone (920) 246-0172
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 930121595 | Other | WI | MEDICARE RAILROAD |
| 30717200 | Medicaid | WI | |
| 104462228 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rerdman10777@ewd.direct.hshs.org | Direct | St Vincent Hospital-Hospital Sisters-Third Order of St Francis |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040728000667 | WI | Practitioner - Emergency Medicine | 3678543527 |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 94.81 of 100
- Quality
- 85.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24509-020 | WI | MD | Emergency Medicine Physician |
| 24509 | WI | MD | Internal Medicine Physician |
Interoperability endpoints
- rerdman10777@ewd.direct.hshs.org
- rerdman891840@direct.emplifyhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665619200000",
"number": "1326090697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 RANDALL AVE",
"city": "DE PERE",
"state": "WI",
"postal_code": "541152638",
"telephone_number": "920-246-0172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 S WEBSTER AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013500",
"telephone_number": "920-433-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERDMAN",
"first_name": "RICHARD",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2022-10-13",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "24509-020",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "24509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "930121595",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30717200",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104462228",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rerdman10777@ewd.direct.hshs.org",
"affiliation": "Y",
"affiliationName": "St Vincent Hospital-Hospital Sisters-Third Order of St Francis",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "835 S Van Buren St",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543013526",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.