NPIMap

Individual provider Active NPI

Andrew Pfaffenbach, M.D.

  • Internal Medicine Physician
  • Appleton, WI
National Provider Identifier
1740654862
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40300-020 Issued in WI
Practice address
2500 E Capitol Dr
Appleton, WI 54911-8735
Phone
(920) 731-5811
Fax
(920) 738-6293
NPI assigned
Dec 1, 2015
Last updated
Sep 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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 40300-020 WI Primary

Addresses

Primary practice location

2500 E Capitol Dr
Appleton, WI 54911-8735

Mailing address

2500 E Capitol Dr
Appleton, WI 54911-8735
Phone (920) 731-5811

Other practice location 1

2693 W Grand Chute Blvd
Appleton, WI 54913-9617
Phone (920) 931-1107

Other practice location 2

200 Theda Clark Medical Plz
Neenah, WI 54956-2721
Phone (920) 727-9650

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
I20220913003235 WI Practitioner - Internal Medicine 6406231315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Wisconsin School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

200 Theda Clark Medical PLZ
Suite 380
Neenah, WI 54956-2790
Phone (920) 727-9650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40300-020WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Sep 10, 2022 Accepting new patients
Thedacare, Incorporated CurrentSince Sep 10, 2022 Accepting new patients
Thedacare Medical Center - Shawano, Inc. Past Accepting new patients

Locations

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

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

200 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 358-1223

200 Theda Clark Medical Plz
Ste 380
Neenah, WI 54956
Phone (920) 727-9650

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

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

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Interoperability endpoints

  • Direct secure messaging: apfaffenbach935@direct.thedacare.org

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1740654862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-731-5811",
            "fax_number": "920-738-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E CAPITOL DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118735",
            "telephone_number": "920-731-5811",
            "fax_number": "920-738-6293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2693 W Grand Chute Blvd",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549139617",
            "country_code": "US",
            "telephone_number": "920-931-1107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Theda Clark Medical Plz",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549562721",
            "country_code": "US",
            "telephone_number": "920-727-9650",
            "fax_number": "920-727-0430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFAFFENBACH",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-01",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "40300-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.