Active NPI
Yevgeniy Vvedenskiy, MD
- Psychiatry Physician
- Neenah, WI
National Provider Identifier
1679141832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 85914
- Practice address
- 130 2ND St
Neenah, WI 54956-2883 - Phone
- (920) 720-2300
- Fax
- (920) 720-3719
- NPI assigned
- Jun 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 125078525 | IL | |
| Psychiatry Physician | 2084P0800X | 85914 | WI | Primary |
Addresses
Primary practice location
130 2ND St
Neenah, WI 54956-2883
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900
Other practice location 1
3333 Green Bay Rd Dept Of
North Chicago, IL 60064-3037
Phone (646) 415-1918
Other practice location 2
1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125078525 | Other | IL | PHYSICIAN 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-2300
130 2ND St
Neenah, WI 54956-2883
Phone (920) 725-0077
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85914 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thedacare, Incorporated | Current | Accepting new patients | |
| Thedacare, Incorporated | Current | Accepting new patients |
Locations
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
1095 Midway Rd
Menasha, WI 54952
Phone (920) 720-3700
130 2nd St
Neenah, WI 54956
Phone (920) 729-2063
3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229
Organizations & group practices 2
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.
-
dba ThedaCare Physicians
- Family Medicine Physician
- New London, WI
- NPI 1376656959
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1023472842
-
- General Acute Care Hospital
- Menasha, WI
- NPI 1720434806
-
- General Acute Care Hospital
- Neenah, WI
- NPI 1518993880
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1861943409
-
- General Acute Care Hospital
- Oshkosh, WI
- NPI 1679937494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752105600000",
"number": "1679141832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 NEENAH CTR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549563070",
"telephone_number": "920-830-5900",
"fax_number": "920-830-5910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 2ND ST",
"city": "NEENAH",
"state": "WI",
"postal_code": "549562883",
"telephone_number": "920-720-2300",
"fax_number": "920-720-3719"
}
],
"practiceLocations": [
{
"address_1": "3333 Green Bay Rd Dept Of",
"address_purpose": "LOCATION",
"city": "North Chicago",
"state": "IL",
"postal_code": "600643037",
"country_code": "US",
"telephone_number": "646-415-1918",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1095 Midway Rd",
"address_purpose": "LOCATION",
"city": "Menasha",
"state": "WI",
"postal_code": "549521115",
"country_code": "US",
"telephone_number": "920-720-2300",
"fax_number": "920-720-3719",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VVEDENSKIY",
"first_name": "YEVGENIY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-15",
"last_updated": "2025-07-10",
"certification_date": "2025-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "125078525",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "85914",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN LICENSE",
"identifier": "125078525",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Neenah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.