Individual provider Active NPI

Mylan Vaugeois Kohler, DO

  • Psychiatry Physician
  • De Pere, WI
National Provider Identifier
1457521866
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
54443-021 Issued in WI
Practice address
1325 Angels Path
De Pere, WI 54115-4050
Phone
(920) 338-2855
Fax
(920) 338-9270
NPI assigned
Mar 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 54443-021 WI Primary

Addresses

Primary practice location

1325 Angels Path
De Pere, WI 54115-4050

Mailing address

PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 433-6073

Other practice location 1

339 Reed Ave
Manitowoc, WI 54220-2020
Phone (920) 320-8600

Other names 1

  • Mylan Ngo Thi Vaugeois Former name

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
I20101102001432 WI Practitioner - Psychiatry 5890989974 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
New York College of Osteo Medicine of New York Institute of Technology, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1325 Angels Path
De Pere, WI 54115-4050
Phone (920) 338-2855

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54443-021WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Psychiatric Center Inc. CurrentSince Dec 5, 2022 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 21, 2025 Accepting new patients
Bellin Psychiatric Center Inc Psychiatry Current Accepting new patients

Locations

1325 Angels Path
De Pere, WI 54115
Phone (920) 338-2855

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

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

2021 S Alverno Rd
Manitowoc, WI 54220
Phone (732) 961-8491

Interoperability endpoints

  • Direct secure messaging: mkohler925727@direct.emplifyhealth.org

Organizations & group practices 4

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1457521866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-433-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ANGELS PATH",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154050",
            "telephone_number": "920-338-2855",
            "fax_number": "920-338-9270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "339 Reed Ave",
            "address_purpose": "LOCATION",
            "city": "Manitowoc",
            "state": "WI",
            "postal_code": "542202020",
            "country_code": "US",
            "telephone_number": "920-320-8600",
            "fax_number": "920-320-8662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHLER",
        "first_name": "MYLAN",
        "middle_name": "VAUGEOIS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "54443-021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYLAN",
            "last_name": "VAUGEOIS",
            "middle_name": "NGO THI",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.