Individual provider Active NPI

Paul A Hudson, MD

  • Interventional Cardiology Physician
  • Green Bay, WI
National Provider Identifier
1417094772
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
56109-20 Issued in WI
Practice address
744 S Webster Ave
2ND Floor
Green Bay, WI 54301-3505
Phone
(920) 433-3500
Fax
(920) 433-7971
NPI assigned
Jan 30, 2007
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 56109-20 WI Primary

Addresses

Primary practice location

744 S Webster Ave
2ND Floor
Green Bay, WI 54301-3505

Mailing address

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

Other practice location 1

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

Other practice location 2

831 Parker Ave
Algoma, WI 54201-1808
Phone (920) 487-3676

Other identifiers 1

IdentifierTypeStateIssuer
ABIM-MOCOtherAMERICAN BOARD OF INTERNAL MEDICINE/CARDIOVASCULAR DISEASE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110826000501 WI Practitioner - Cardiovascular Disease (Cardiology) 6103918248 Reassigns benefits to 4 organizations
I20110915000807 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6103918248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis HospitalGroup PAC ID 5991604753, 85 clinicians
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, shared by 12 NPIs, 217 clinicians

Practice addresses (Care Compare)

3401 Ludington St
Escanaba, MI 49829-1300
Phone (906) 786-5707

3409 Ludington St
Escanaba, MI 49829-4213

744 S Webster Ave
FL 2
Green Bay, WI 54301-3505
Phone (920) 445-7226

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting27
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56109-20WIMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oconto Hospital & Medical Center Inc CurrentSince Oct 1, 2012 Accepting new patients
Froedtert Manitowoc Medical Group, LLC CurrentSince Apr 1, 2022 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Aug 8, 2011 Accepting new patients
St. Francis Hospital Current Accepting new patients
St Francis Hospital CurrentSince Apr 29, 2024 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Aug 8, 2011 Accepting new patients
St. Francis Hospital CurrentSince Apr 29, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Oct 1, 2012 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 8, 2024 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc PastSince Jun 8, 2024 Accepting new patients
Cardiovascular Associates PC Interventional Cardiology Past Accepting new patients

Locations

2525 5th Ave S
Escanaba, MI 49829
Phone (906) 233-4276

3409 Ludington St
Ste 104
Escanaba, MI 49829
Phone (906) 786-8343

3409 Ludington St
Ste 206
Escanaba, MI 49829
Phone (906) 786-7471

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

831 Parker Ave
Algoma, WI 54201
Phone (920) 487-3084

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

744 S Webster Ave
Fl 2
Green Bay, WI 54301

744 S Webster Ave
#2
Green Bay, WI 54301

2300 Western Ave
Manitowoc, WI 54220
Phone (920) 320-2011

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

1414 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 320-2011

Interoperability endpoints

  • Direct secure messaging: phudson916837@direct.emplifyhealth.org
  • Direct secure messaging: phudson33101@direct.thedacare.org

Organizations & group practices 12

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 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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1417094772",
    "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": "744 S WEBSTER AVE",
            "address_2": "2ND FLOOR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-433-3500",
            "fax_number": "920-433-7971"
        }
    ],
    "practiceLocations": [
        {
            "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"
        },
        {
            "address_1": "831 Parker Ave",
            "address_purpose": "LOCATION",
            "city": "Algoma",
            "state": "WI",
            "postal_code": "542011808",
            "country_code": "US",
            "telephone_number": "920-487-3676",
            "fax_number": "920-487-3084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "PAUL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WI",
            "license": "56109-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD OF INTERNAL MEDICINE/CARDIOVASCULAR DISEASE",
            "identifier": "ABIM-MOC",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.