Individual provider Active NPI

Bruce R Danz, MD

  • Family Medicine Physician
  • Kaukauna, WI
National Provider Identifier
1386600666
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0024090 Issued in WI
Practice address
305 E 12TH St
Kaukauna, WI 54130-2865
Phone
(920) 766-4656
Fax
(920) 766-4659
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0024090 WI Primary

Addresses

Primary practice location

305 E 12TH St
Kaukauna, WI 54130-2865

Mailing address

305 E 12TH St
Kaukauna, WI 54130-2865
Phone (920) 766-4656

Other identifiers 1

IdentifierTypeStateIssuer
30522800MedicaidWI

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
I20100522000158 WI Practitioner - Family Practice 3678573979 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024090WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaukauna Clinic, S.C. Family Medicine CurrentSince Oct 1, 1989 Accepting new patients

Locations

305 E 12th St
Kaukauna, WI 54130
Phone (920) 731-3111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386600666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E 12TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302865",
            "telephone_number": "920-766-4656",
            "fax_number": "920-766-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 12TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302865",
            "telephone_number": "920-766-4656",
            "fax_number": "920-766-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANZ",
        "first_name": "BRUCE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "0024090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30522800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

Verify at the official NPI Registry.