NPIMap

Individual provider Active NPI

Benjamin D Schlais, MD

  • Family Medicine Physician
  • Shawano, WI
National Provider Identifier
1699017913
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
62908-20 Issued in WI
Practice address
100 County Hwy B
Shawano, WI 54166
Phone
(715) 524-2161
NPI assigned
Mar 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 62908-20 WI Primary

Addresses

Primary practice location

100 County Hwy B
Shawano, WI 54166

Mailing address

100 County Hwy B
Shawano, WI 54166
Phone (715) 524-2161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150512001507 WI Practitioner - Family Practice 3072832120 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians
Thedacare Medical Center - Shawano, Inc.Group PAC ID 5890605836, 38 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Thedacare at Home Hospice, Appleton, WI, CCN 521504
  • Moments Hospice of Green Bay Hospice, Green Bay, WI, CCN 521619
  • Thedacare Medical Center - Shawano Hospital, Shawano, WI, CCN 521346
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28
Upper gastrointestinal (GI) endoscopy for acid reflux29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62908-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Urgent Care Physcians, LTD CurrentSince Apr 1, 2015 Accepting new patients
Thedacare, Incorporated Family Medicine CurrentSince Jul 15, 2016 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

3329 Express Ct
Appleton, WI 54915
Phone (920) 733-5900

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

122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

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

Interoperability endpoints

  • Direct secure messaging: bschlais61581@direct.thedacare.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 and National Provider Directory roles.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1699017913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COUNTY HWY B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "54166",
            "telephone_number": "715-524-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY HWY B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "54166",
            "telephone_number": "715-524-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLAIS",
        "first_name": "BENJAMIN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "62908-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

Verify at the official NPI Registry.