NPIMap

Individual provider Active NPI

Gregory J Swanson, MD

  • Otolaryngology Physician
  • Appleton, WI
National Provider Identifier
1710971783
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
44480 Issued in WI
Practice address
1501 S Madison St
Appleton, WI 54915-1846
Phone
(920) 730-4443
NPI assigned
Sep 7, 2005
Last updated
Jun 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 44480 WI Primary

Addresses

Primary practice location

1501 S Madison St
Appleton, WI 54915-1846

Mailing address

1501 S Madison St
Appleton, WI 54915-1846
Phone (920) 730-4443

Other identifiers 1

IdentifierTypeStateIssuer
34200600MedicaidWI

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
I20100520000569 WI Practitioner - Otolaryngology 8628107281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Rush Medical College of Rush University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Specialists of Wisconsin SCGroup PAC ID 9830086925, 28 clinicians

Practice addresses (Care Compare)

119 E Bell St
Neenah, WI 54956-4993
Phone (920) 969-1768

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Calumet Hospital, Inc CurrentSince Feb 22, 2016 Accepting new patients
Ear Nose and Throat Specialists of Wisconsin, SC Current Accepting new patients
Ear Nose and Throat Specialists of Wisconsin SC Otolaryngology CurrentSince Jan 1, 2019 Accepting new patients

Locations

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

444 N Westhill Blvd
Appleton, WI 54914
Phone (920) 750-7000

614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042

618 Memorial Dr
Chilton, WI 53014
Phone (920) 849-3800

119 E Bell St
Neenah, WI 54956

515 S Washburn St
Ste 200
Oshkosh, WI 54904

855 N Westhaven Dr
#200
Oshkosh, WI 54904

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBAAA

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

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1710971783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151846",
            "telephone_number": "920-730-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151846",
            "telephone_number": "920-730-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "44480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34200600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.