Paul Henry Sumnicht, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25454 Issued in WI

Practice address

1 W Lincoln St
Waupun, WI 53963-1949

Phone

(920) 324-7259

Fax

(920) 324-7254

NPI assigned

Feb 20, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Oneida Nation

  • Clinic/Center
  • Oneida, WI
  • NPI 1740278308
  Medicare reassignment NPD
• Wojciech a. Gadowski, MD, SC

  • Family Medicine Physician
  • Menasha, WI
  • NPI 1366551293
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639214752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S KELLER PARK DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W LINCOLN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631949",
            "telephone_number": "920-324-7259",
            "fax_number": "920-324-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMNICHT",
        "first_name": "PAUL",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "25454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Marie Smits, APNP
• St. Marys Dean Ventures Inc.
• Olly Christian Stewart, PT, DPT
• Kathryn Therese Sullivan Dillie, MD, PHD
• Jessica Y Sullivan, NP
• Tammy Narance LPC SC
• Samantha L Thiede, APNP
• Donna L Thomas, OTR, CKTP
• Peter W Timmermans, MD
• Amy J. Tisdale, LPN

• Family Medicine Physician in Waupun, WI
• Providers in Waupun, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.