Individual provider Active NPI

Basil P Spyropoulos, M.D.

  • Psychiatry Physician
  • Manitowoc, WI
National Provider Identifier
1649209594
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
47302 Issued in WI
Practice address
926 S 8TH St
Manitowoc, WI 54220-4535
Phone
(920) 683-4230
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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 47302 WI Primary

Addresses

Primary practice location

926 S 8TH St
Manitowoc, WI 54220-4535

Mailing address

PO Box 764
Lake Geneva, WI 53147-0764
Phone (262) 248-2640

Other identifiers 1

IdentifierTypeStateIssuer
47302OtherWISTATE LICENSE

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
I20050103000012 WI Practitioner - Psychiatry 0648259739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Southern Illinois University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Manitowoc County Courthouse Comptrollers OfficeGroup PAC ID 6800707480, 2 clinicians

Practice addresses (Care Compare)

926 S 8TH St
Manitowoc, WI 54220-4535
Phone (920) 683-4253

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47302WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Community Health Care, Inc CurrentSince May 1, 2020 Accepting new patients
Lakeshore Community Health Care, Inc Current Accepting new patients
Lakeshore Community Health Care, Inc CurrentSince May 1, 2020 Accepting new patients
Liz Hanson Will, LLC Past Accepting new patients

Locations

2719 Calumet Ave
Manitowoc, WI 54220
Phone (920) 686-2333

819 Kentucky Ave
Sheboygan, WI 53081
Phone (920) 783-6633

908 W Washington St
West Bend, WI 53095
Phone (262) 306-3500

Interoperability endpoints

  • Direct secure messaging: bspyropoulos364094@direct.ochin.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1649209594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 764",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531470764",
            "telephone_number": "262-248-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 S 8TH ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204535",
            "telephone_number": "920-683-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPYROPOULOS",
        "first_name": "BASIL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "47302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "47302",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.