Individual provider Active NPI

David A Janssen, M.D.

  • Plastic Surgery Physician
  • Oshkosh, WI
National Provider Identifier
1366420812
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
34699-20 Issued in WI
Practice address
2400 Witzel Ave Ste a
Oshkosh, WI 54904-8375
Phone
(920) 233-1540
Fax
(920) 651-6951
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 34699-20 WI Primary

Addresses

Primary practice location

2400 Witzel Ave Ste a
Oshkosh, WI 54904-8375

Mailing address

2400 Witzel Ave Ste a
Oshkosh, WI 54904-8375
Phone (920) 233-1540

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006001176 WI Practitioner - Plastic and Reconstructive Surgery 3476465378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Wisconsin School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Valley Plastic Surgery, S.C.Group PAC ID 6608965611, 4 clinicians

Practice addresses (Care Compare)

2400 Witzel Ave
Suite a
Oshkosh, WI 54904-8374

2400 Witzel Ave
Suite a
Oshkosh, WI 54904-8375
Phone (920) 233-1540

2400 Witzel Ave a
Oshkosh, WI 54904-8375

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Varicose vein removal1-10
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34699-20WIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Plastic Surgery, S.C. Specialist CurrentSince Sep 1, 1998 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

2500 E Capitol Dr
Ste 1500
Appleton, WI 54911
Phone (920) 882-6333

2400 Witzel Ave
Ste A
Oshkosh, WI 54904
Phone (920) 233-1540

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1366420812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WITZEL AVE STE A",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048375",
            "telephone_number": "920-233-1540",
            "fax_number": "920-651-6951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 WITZEL AVE STE A",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549048375",
            "telephone_number": "920-233-1540",
            "fax_number": "920-651-6951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSSEN",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "34699-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.