Individual provider Active NPI

Kyle Haselton, MD

  • Anesthesiology Physician
  • Green Bay, WI
National Provider Identifier
1831620491
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
82380 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 490-9046
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 28961 MN
Anesthesiology Physician 207L00000X 64291 MN
Internal Medicine Physician 207R00000X 28386 MN
Anesthesiology Physician 207L00000X 82380 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

1306 Hannah St
Green Bay, WI 54303-1900

Other practice location 1

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Other identifiers 1

IdentifierTypeStateIssuer
1831620491MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other Dean Health Systems, Inc
Direct Messaging Address khaselton571800@direct-ehr-ssmhc.com Direct Dean Health Systems, Inc

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230725002960 WI Practitioner - Anesthesiology 4587936224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Clinic LLPGroup PAC ID 4385554328, 197 clinicians
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8250

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28961MNMDClinical Social Worker
28386MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP CurrentSince Aug 1, 2023 Accepting new patients
Baycare Clinic LLP Anesthesiology Current Accepting new patients
Aurora Medical Group, Inc. Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2023 Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

1500 Arbor Way
Kaukauna, WI 54130
Phone (877) 229-2273

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

719 Doctors Ct
Oshkosh, WI 54901
Phone (920) 235-0066

Interoperability endpoints

  • Direct secure messaging: khaselton571800@direct-ehr-ssmhc.com

Organizations & group practices 5

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 3

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1831620491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 HANNAH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-490-9046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-251-6100",
            "fax_number": "608-258-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HASELTON",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "28961",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "64291",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "28386",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "82380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831620491",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Dean Health Systems, Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khaselton571800@direct-ehr-ssmhc.com",
            "affiliation": "Y",
            "affiliationName": "Dean Health Systems, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "700 S Park St",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537151830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.