Individual provider Active NPI

William G Doubek, M.D.

  • Plastic Surgery Physician
  • Oshkosh, WI
National Provider Identifier
1457339913
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
39879-20 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 Nov 12, 2020

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 39879-20 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
I20101007000180 WI Practitioner - Plastic and Reconstructive Surgery 0749379766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
St. Louis College of Physicians and Surgeons, 1991
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39879-20WIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Valley Plastic Surgery, S.C. Specialist CurrentSince Jul 13, 1998 Accepting new patients
Memorial Hospital Inc Past Accepting new patients
Renaissance Surgery Center LLC PastSince Sep 11, 2007 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 3

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": "1605139200000",
    "number": "1457339913",
    "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": "DOUBEK",
        "first_name": "WILLIAM",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "39879-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.