Eric G Eberts, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

41754 Issued in WI

Practice address

200 Theda Clark Medical PLZ
Ste 130
Neenah, WI 54956-2790

Phone

(920) 729-7105

Fax

(920) 720-2150

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Theda Clark OB Hospitalists SC

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1295510196

  Obstetrics & Gynecology, WI

  Medicare reassignment NPD Authorized official
• Women'S Care of Wisconsin S.C.

  • Obstetrics & Gynecology Physician
  • Neenah, WI
  • NPI 1003811993

  Obstetrics & Gynecology, WI

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1790780708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3232 N BALLARD RD STE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118804",
            "telephone_number": "920-729-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ",
            "address_2": "STE 130",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562790",
            "telephone_number": "920-729-7105",
            "fax_number": "920-720-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERTS",
        "first_name": "ERIC",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "41754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32389700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie K Dziewit, APNP
• Richard Anton Dziewit, CRNA
• E a Darkow DDS SC
• Ear Nose and Throat Specialists of Wisconsin SC
• Ear Nose and Throat Specialists of Wisconsin, SC
• Timothy R Edison, MD
• John Anderson Edwards, MD
• Emma Eggen, RD
• Peter Eggert
• David B Ehlert, D.D.S.

• All providers in Neenah, WI
• Obstetrics & Gynecology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.