NPIMap

Individual provider Active NPI

Paul Anderson

  • Anesthesiology Physician
  • Green Bay, WI
National Provider Identifier
1750648481
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
61713-20 Issued in WI
Practice address
744 S Webster Ave
Green Bay, WI 54301
Phone
(920) 433-3500
NPI assigned
Apr 19, 2012
Last updated
Jun 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 61713-20 WI Primary

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 1

  • N/a N/a N/a Other name

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
I20160502000561 WI Practitioner - Anesthesiology 4183943673 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Wisconsin, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians
Bellin Anesthesia Associates SCGroup PAC ID 1254357684, 34 clinicians
Green Bay Anesthesia Assoc. SCGroup PAC ID 4486613858, 70 clinicians

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Green Bay Anesthesia Assoc. SC Anesthesiology CurrentSince Jul 1, 2025 Accepting new patients
Agnesian Healthcare, Inc CurrentSince Aug 9, 2024 Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 9, 2024 Accepting new patients
Bellin Anesthesia Associates, S.C. Anesthesiology CurrentSince Jun 1, 2016 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

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

Bin 88263
Milwaukee, WI 53288

Bin 88848
Milwaukee, WI 53288

Organizations & group practices 4

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1750648481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S EXECUTIVE DR",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054257",
            "telephone_number": "920-433-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-433-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-19",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "61713-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N/A",
            "last_name": "N/A",
            "middle_name": "N/A",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.