NPIMap

Individual provider Active NPI

Philip Andrew Yazbak, MD

  • Neurological Surgery Physician
  • Neenah, WI
National Provider Identifier
1538119649
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
36632 Issued in WI
Practice address
1305 W American Dr
Neenah, WI 54956-1993
Phone
(920) 725-9373
Fax
(920) 720-7392
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 36632 WI Primary

Addresses

Primary practice location

1305 W American Dr
Neenah, WI 54956-1993

Mailing address

1305 W American Dr
Neenah, WI 54956-1993
Phone (920) 725-9373

Other identifiers 1

IdentifierTypeStateIssuer
32127400MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pyazbak33407@ewd.direct.hshs.org Direct St Vincent Hospital-Hospital Sisters-Third Order of St Francis

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070518000320 WI Practitioner - Neurosurgery 4880508779 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Geisel School of Medicine at Dartmouth, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Neuroscience Group of Northeast Wisconsin SCGroup PAC ID 6204740186, 57 clinicians

Practice addresses (Care Compare)

130 2ND St W Pavillion 2ND Floor
Neenah, WI 54956-2883
Phone (920) 725-9373

1305 W American Dr
Neenah, WI 54956-1993
Phone (920) 725-9373

1818 N Meade St
Neuroscience Group
Appleton, WI 54911-3454
Phone (920) 725-9373

2400 E Capitol Dr
Appleton, WI 54911-8728
Phone (920) 729-7687

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (800) 201-1194

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion25
Laminectomy or laminotomy (partial removal of spine bones)18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients
The Neuroscience Group of Northeast Wisconsin SC Neurological Surgery CurrentSince Jul 1, 1997 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients
St. Clare Memorial Hospital, Inc. CurrentSince Jul 1, 2022 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Jul 1, 2022 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients
The Neuroscience Group of Northeast Wisconsin, SC Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 1, 2022 Accepting new patients

Locations

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1305 West American Dr
Neenah, WI 54956
Phone (920) 729-7687

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Interoperability endpoints

  • Direct secure messaging: pyazbak20918@direct.thedacare.org
  • Direct secure messaging: pyazbak33407@ewd.direct.hshs.org

Organizations & group practices 8

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 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1538119649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W AMERICAN DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561993",
            "telephone_number": "920-725-9373",
            "fax_number": "920-720-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W AMERICAN DR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561993",
            "telephone_number": "920-725-9373",
            "fax_number": "920-720-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZBAK",
        "first_name": "PHILIP",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WI",
            "license": "36632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32127400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pyazbak33407@ewd.direct.hshs.org",
            "affiliation": "Y",
            "affiliationName": "St Vincent Hospital-Hospital Sisters-Third Order of St Francis",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1821 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543012253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.