Individual provider Active NPI

Eric M Paulos, PT

  • Physical Therapist
  • Green Bay, WI
National Provider Identifier
1407401912
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14645 Issued in WI
Practice address
1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone
(920) 430-4888
Fax
(920) 430-4889
NPI assigned
Aug 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14645 WI Primary

Addresses

Primary practice location

1970 S Ridge Rd
Green Bay, WI 54304-4125

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

Other practice location 1

964 W Ryan St Ste B
Brillion, WI 54110-1077
Phone (920) 756-2055

Other practice location 2

107 E Highland Dr
Oconto Falls, WI 54154-1002
Phone (920) 846-3092

Other practice location 3

820 Arbutus Ave
Oconto, WI 54153-2004
Phone (920) 835-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210615002753 WI Practitioner - Physical Therapist in Private Practice 0446580450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1970 S Ridge Rd
Green Bay, WI 54304-4125
Phone (920) 430-4888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Jun 7, 2021 Accepting new patients
Bellin Memorial Hospital Inc Physical Therapist CurrentSince Jun 7, 2021 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jun 7, 2021 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jun 7, 2021 Accepting new patients
Bellin Memorial Hospital Inc Past Accepting new patients

Locations

964 W Ryan St
Ste B
Brillion, WI 54110
Phone (920) 756-2055

218 S US Highway 141
Crivitz, WI 54114
Phone (715) 854-7477

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

107 E Highland Dr
Oconto Falls, WI 54154
Phone (920) 846-0509

Interoperability endpoints

  • Direct secure messaging: epaulos307843@direct.thedacare.org

Organizations & group practices 7

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": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1407401912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 S RIDGE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044125",
            "telephone_number": "920-430-4888",
            "fax_number": "920-430-4889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "964 W Ryan St Ste B",
            "address_purpose": "LOCATION",
            "city": "Brillion",
            "state": "WI",
            "postal_code": "541101077",
            "country_code": "US",
            "telephone_number": "920-756-2055",
            "fax_number": "920-756-3350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 E Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541002",
            "country_code": "US",
            "telephone_number": "920-846-3092",
            "fax_number": "920-846-8313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Arbutus Ave",
            "address_purpose": "LOCATION",
            "city": "Oconto",
            "state": "WI",
            "postal_code": "541532004",
            "country_code": "US",
            "telephone_number": "920-835-1100",
            "fax_number": "920-835-1099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAULOS",
        "first_name": "ERIC",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-02",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.