NPIMap

Individual provider Active NPI

Allison Ann Brubaker, M.D.

  • Obstetrics & Gynecology Physician
  • Neenah, WI
National Provider Identifier
1386094050
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2016018973 Issued in MO
Practice address
200 Theda Clark Medical PLZ Ste 130
Neenah, WI 54956-2790
Phone
(920) 729-7105
NPI assigned
Jun 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2016018973 MO Primary

Addresses

Primary practice location

200 Theda Clark Medical PLZ Ste 130
Neenah, WI 54956-2790

Mailing address

3232 N Ballard Rd Ste 100
Appleton, WI 54911-8804
Phone (920) 729-7105

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
I20200811002407 WI Practitioner - Obstetrics/Gynecology 0749606556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care of Wisconsin SCGroup PAC ID 3072416601, 23 clinicians

Practice addresses (Care Compare)

200 Theda Clark Medical PLZ
Suite 130
Neenah, WI 54956-2790
Phone (920) 729-7105

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016018973MOMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care of Wisconsin S.C. Obstetrics & Gynecology CurrentSince Aug 31, 2020 Accepting new patients
Theda Clark OB Hospitalists SC Obstetrics & Gynecology CurrentSince Sep 5, 2023 Accepting new patients

Locations

5485 W Grande Market Dr
Ste C
Appleton, WI 54913

3232 N Ballard Rd
Ste 100
Appleton, WI 54911

225 Memorial Dr
Ste 2030
Berlin, WI 54923
Phone (920) 361-5737

200 Theda Clark Medical Plz
Ste 130
Neenah, WI 54956

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

491 S Washburn St
Oshkosh, WI 54904
Phone (920) 292-1555

100 County Road B
Ste 4
Shawano, WI 54166

E3277 Apple Tree Ln
Waupaca, WI 54981
Phone (715) 256-0358

Interoperability endpoints

  • Direct secure messaging: abrubaker296329@direct.thedacare.org

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 12

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1386094050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD STE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-729-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ STE 130",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562790",
            "telephone_number": "920-729-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "ALLISON",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2016018973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.