NPIMap

Organization Active NPI

Valley Urologic Associates, S.C.

  • Urology Physician
  • Waupaca, WI
National Provider Identifier
1689791899
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
VALLEY UROLOGIC ASSOCIATES, S.C.
Practice address
800 Riverside Dr
Riverside Medical Center Waupaca
Waupaca, WI 54981-1943
Phone
(920) 739-3537
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Elmer Vlach Jr., M.D.
Title
President
Phone
(920) 739-3537

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

800 Riverside Dr
Riverside Medical Center Waupaca
Waupaca, WI 54981-1943

Mailing address

820 E Grant St
Appleton, WI 54911-3483
Phone (920) 739-3537

Other identifiers 2

IdentifierTypeStateIssuer
32748300MedicaidWI
989963OtherWIUNITED HEALTHCARE

National Provider Directory

National Provider Directory
Tax ID family
Valley Urologic Associates SC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689791899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E GRANT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549113483",
            "telephone_number": "920-739-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 RIVERSIDE DR",
            "address_2": "RIVERSIDE MEDICAL CENTER WAUPACA",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811943",
            "telephone_number": "920-739-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY UROLOGIC ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VLACH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ELMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-739-3537",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32748300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "989963",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.