NPIMap

Individual provider Active NPI

Michael T Werner, MD

  • Family Medicine Physician
  • Appleton, WI
National Provider Identifier
1811965494
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47092 Issued in WI
Practice address
59 Park PL Ste 100
Appleton, WI 54914-8230
Phone
(920) 996-1000
Fax
(920) 997-8303
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47092 WI Primary

Addresses

Primary practice location

59 Park PL Ste 100
Appleton, WI 54914-8230

Mailing address

3916 N Intertech CT
Appleton, WI 54913-6957
Phone (920) 996-1000

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
I20070111000088 WI Practitioner - Family Practice 3476553777 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mosaic Family Health IncGroup PAC ID 4082925243, 14 clinicians
Primary Care Associates of Appleton, LTDGroup PAC ID 1052348612, 31 clinicians

Practice addresses (Care Compare)

229 S Morrison St
Appleton, WI 54911-5725
Phone (920) 832-2783

3916 N Intertech CT
Appleton, WI 54913-6957
Phone (920) 996-1000

Hospital & facility affiliations

  • Thedacare at Home Home health agency, Appleton, WI, CCN 527010
  • Thedacare at Home Hospice, Appleton, WI, CCN 521504
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy21
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Associates of Appleton, LTD Family Medicine CurrentSince Sep 14, 2019 Accepting new patients
Mosaic Family Health, Inc Family Medicine CurrentSince Jul 1, 2015 Accepting new patients
Thedacare, Incorporated Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Radiology Associates of Appleton, S.C. PastSince Sep 25, 2019 Accepting new patients

Locations

229 S Morrison St
Appleton, WI 54911
Phone (920) 832-2783

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

3916 N Intertech Ct
Appleton, WI 54913
Phone (920) 996-1000

100 N Oneida St
Appleton, WI 54911
Phone (920) 832-2783

59 Park Pl
Ste 100
Appleton, WI 54914
Phone (920) 996-1000

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

305 E 12th St
Kaukauna, WI 54130
Phone (920) 731-3111

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

Interoperability endpoints

  • Direct secure messaging: mwerner19325@direct.thedacare.org

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 and National Provider Directory roles.

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1811965494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 N INTERTECH CT",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549136957",
            "telephone_number": "920-996-1000",
            "fax_number": "920-996-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 PARK PL STE 100",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148230",
            "telephone_number": "920-996-1000",
            "fax_number": "920-997-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNER",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "47092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.