Individual provider Active NPI

Brian J Erdmann, MD

  • Internal Medicine Physician
  • Rhinelander, WI
National Provider Identifier
1679689582
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39040 Issued in WI
Practice address
580 Shepard St
Rhinelander, WI 54501-3552
Phone
(715) 420-1831
Fax
(715) 420-1829
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39040 WI Primary

Addresses

Primary practice location

580 Shepard St
Rhinelander, WI 54501-3552

Mailing address

580 Shepard St
Rhinelander, WI 54501-3552
Phone (715) 420-1831

Other identifiers 2

IdentifierTypeStateIssuer
64730OtherWISECURITY HEALTH PLAN
32479700MedicaidWI

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
I20040528000863 WI Practitioner - Internal MedicinePractitioner - Emergency Medicine 2264413780 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

100 County Rd B
Shawano, WI 54166-7072
Phone (920) 358-1223

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39040WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Jan 1, 2024 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

Interoperability endpoints

  • Direct secure messaging: brian.erdmann@41147548106756.direct.elationemr.com
  • Direct secure messaging: berdmann325997@direct.thedacare.org
  • Direct secure messaging: brian.erdmann@337248305217540.direct.elationemr.com

Organizations & group practices 3

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 7

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1679689582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 SHEPARD ST",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545013552",
            "telephone_number": "715-420-1831",
            "fax_number": "715-420-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 SHEPARD ST",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545013552",
            "telephone_number": "715-420-1831",
            "fax_number": "715-420-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERDMANN",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "39040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN",
            "identifier": "64730",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32479700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinelander, WI

Sources for this page

Verify at the official NPI Registry.