NPIMap

Individual provider Active NPI

Colby J Seegmiller, DO

  • Surgery Physician
  • Neenah, WI
National Provider Identifier
1336558832
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
67830-21 Issued in WI
Practice address
100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763
Phone
(920) 725-4527
Fax
(920) 725-4527
NPI assigned
Aug 8, 2014
Last updated
Dec 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 67830-21 WI Primary

Addresses

Primary practice location

100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763

Mailing address

100 Theda Clark Medical PLZ Ste 400
Neenah, WI 54956-2763
Phone (920) 725-4527

Other identifiers 1

IdentifierTypeStateIssuer
1336558832MedicaidWI

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
I20211006001034 WI Practitioner - General Surgery 5597057984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates of Neenah, S.C.Group PAC ID 4486625258, 29 clinicians

Practice addresses (Care Compare)

100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Phone (920) 725-4527

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy36
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux30
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67830-21WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of Neenah, S.C. Surgery CurrentSince Aug 16, 2021 Accepting new patients

Locations

820 E Grant St
Ste 230
Appleton, WI 54911
Phone (920) 725-4527

100 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 722-7747

100 Theda Clark Medical Plz
Ste 400
Neenah, WI 54956
Phone (414) 725-4527

Organizations & group practices 1

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1336558832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 THEDA CLARK MEDICAL PLZ STE 400",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562763",
            "telephone_number": "920-725-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 THEDA CLARK MEDICAL PLZ STE 400",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562763",
            "telephone_number": "920-725-4527",
            "fax_number": "920-725-4527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEEGMILLER",
        "first_name": "COLBY",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-08",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "67830-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336558832",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.