Individual provider Active NPI

Robert Lee Hausserman, M.D.

  • Orthopaedic Surgery Physician
  • Appleton, WI
National Provider Identifier
1821028135
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
19276 Issued in WI
Practice address
2105 E Enterprise Ave
Ste 112
Appleton, WI 54913
Phone
(920) 731-3111
Fax
(920) 731-7133
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 19276 WI Primary

Addresses

Primary practice location

2105 E Enterprise Ave
Ste 112
Appleton, WI 54913

Mailing address

2105 E Enterprise Ave
Ste 112
Appleton, WI 54913
Phone (920) 731-3111

Other identifiers 1

IdentifierTypeStateIssuer
30290000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robert L. Hausserman, M.D.,S.C. PastSince Jan 1, 1966 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821028135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE",
            "address_2": "STE 112",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-731-3111",
            "fax_number": "920-731-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E ENTERPRISE AVE",
            "address_2": "STE 112",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-731-3111",
            "fax_number": "920-731-7133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSSERMAN",
        "first_name": "ROBERT",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "19276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30290000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.