Individual provider Active NPI

Scott C Westenberg, MD

  • Emergency Medicine Physician
  • Green Bay, WI
National Provider Identifier
1700807419
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
32244 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 288-4060
Fax
(920) 288-4067
NPI assigned
Jul 21, 2006
Last updated
Apr 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 32244 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

1035 Kepler Dr
Green Bay, WI 54311-8320

Other identifiers 1

IdentifierTypeStateIssuer
31711600MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swestenberg41086@direct.aurora.org

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
I20050309000401 WI Practitioner - Emergency Medicine 8921910175 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32244WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP CurrentSince Feb 1, 1999 Accepting new patients
Baycare Clinic LLP Emergency Medicine CurrentSince Feb 1, 1999 Accepting new patients

Locations

1035 Kepler Dr
Green Bay, WI 54311

164 N Broadway
Green Bay, WI 54303
Phone (920) 965-4055

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

1500 Arbor Way
Kaukauna, WI 54130
Phone (877) 229-2273

3100 Shore Dr
Marinette, WI 54143
Phone (715) 735-4200

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

5000 Memorial Dr
Two Rivers, WI 54241
Phone (920) 794-5000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1700807419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-4060",
            "fax_number": "920-288-4067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTENBERG",
        "first_name": "SCOTT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "32244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31711600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swestenberg41086@direct.aurora.org",
            "affiliation": "N",
            "address_1": "2845 Greenbrier Rd",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543116519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.