Paul Anderson
Individual provider Active NPI Anesthesiology Physician · Green Bay, WI
NPI 1750648481 · NPPES record last updated Jun 27, 2018
Key facts
- NPI
- 1750648481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 61713-20 (WI)
- Practice address
- 744 S Webster Ave
Green Bay, WI 54301 - Phone
- (920) 433-3500
- NPI assigned
- Apr 19, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Medical College of Wisconsin, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Agnesian Healthcare Inc
Bellin Anesthesia Associates SC
Green Bay Anesthesia Assoc. SC
Practice addresses (Care Compare)
430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 929-2300
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-3500
835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111
Hospital & facility affiliations
- Bellin Memorial Hospital
- SSM Health St Agnes Hospital-Fond Du Lac
- St Vincent Hospital
- Bellin Health Oconto Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160502000561 | WI | Practitioner - Anesthesiology | 4183943673 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Bay Anesthesia Assoc. SC | Anesthesiology | Current |
Accepting new patients |
| Agnesian Healthcare Inc | Current |
Accepting new patients | |
| Bellin Anesthesia Associates, S.C. | Anesthesiology | Current |
Accepting new patients |
| Agnesian Healthcare, Inc | Current |
Accepting new patients |
Locations
225 S Executive Dr
Brookfield, WI 53005
Phone (262) 787-4026
614 Memorial Dr
Chilton, WI 53014
Phone (800) 458-4042
430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200
420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
Bin 88263
Milwaukee, WI 53288
Bin 88848
Milwaukee, WI 53288
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 61713-20 | WI | Yes |
Addresses
Primary practice location
744 S Webster Ave
Green Bay, WI 54301
Mailing address
225 S Executive Dr
Brookfield, WI 53005-4257
Phone (920) 433-3500
Other names
- N/a N/a N/a
Other providers in Green Bay, WI
- Laura Mae Anderson
- Laurie Lynn Anderson
- Lisa A Anderson
- Lori T Anderson
- Melissa A Anderson
- Polly Alison Anderson
- Robert James Anderson
- Sara Ann Anderson
- Sara L Anderson
- Sara Lynn Anderson
All providers in Green Bay, WI · Anesthesiology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.