Wisconsin Institute of Plastic Surgery SC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

WISCONSIN INSTITUTE OF PLASTIC SURGERY SC

Doing business as

Wisconsin Oculoplastics SC

Practice address

2700 E Enterprise Ave Ste a
Appleton, WI 54913-7656

Phone

(920) 965-1234

Fax

(920) 965-1232

NPI assigned

Jan 9, 2007

Last updated

Oct 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wendy J Justus

Title

Practice Manager

Phone

(920) 965-1234

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Wisconsin Oculoplastics SC Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tina M. Sauerhammer, M.D.

  • Surgery Physician
  • Appleton, WI
  • NPI 1194768309
  Medicare reassignment Care Compare group NPD
• Megan Maccarthy, PA-C

  • Physician Assistant
  • De Pere, WI
  • NPI 1316979248
  Medicare reassignment Care Compare group
• Amanda S Olsen, PA-C

  • Physician Assistant
  • De Pere, WI
  • NPI 1407154354
  Medicare reassignment Care Compare group
• Colleen M Van Egeren, P.A.

  • Physician Assistant
  • Green Bay, WI
  • NPI 1265628507
  Medicare reassignment Care Compare group
• Frank M Chybowski, MD

  • Urology Physician
  • Appleton, WI
  • NPI 1487648242
  NPD (past)
• Ronald W Slovick, MD

  • Urology Physician
  • Appleton, WI
  • NPI 1932163524
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634774400000",
    "number": "1487703880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 DICKINSON RD STE 17B",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154056",
            "telephone_number": "920-965-1234",
            "fax_number": "920-965-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E ENTERPRISE AVE STE A",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137656",
            "telephone_number": "920-965-1234",
            "fax_number": "920-965-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN INSTITUTE OF PLASTIC SURGERY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A",
        "authorized_official_last_name": "JUSTUS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "920-965-1234"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3677500",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wips.ema.md",
            "affiliation": "N",
            "address_1": "2700 E Enterprise Ave Ste A",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549137656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Wisconsin Oculoplastics SC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Plastic Surgery Physician in Appleton, WI
• Providers in Appleton, WI by specialty
• Plastic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.