Active NPI
Per R Anderas, MD
- Surgery Physician
- Green Bay, WI
National Provider Identifier
1861437303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 24450
- Practice address
- 2845 Greenbrier Rd Ste 230
Green Bay, WI 54311-6519 - Phone
- (920) 288-8250
- Fax
- (920) 288-8255
- NPI assigned
- Jun 18, 2006
- Last updated
- Aug 28, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 24450 | WI | Primary |
Addresses
Primary practice location
2845 Greenbrier Rd Ste 230
Green Bay, WI 54311-6519
Mailing address
2845 Greenbrier Rd Ste 230
PO Box 8900
Green Bay, WI 54308-8900
Phone (920) 288-8250
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30548500 | Medicaid | WI | |
| 020040912 | Other | WI | RAILROAD |
| 104082668 | Medicaid | MI |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24450 | WI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Clinic LLP | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1134490758
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219881600000",
"number": "1861437303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2845 GREENBRIER RD STE 230",
"address_2": "PO BOX 8900",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543088900",
"telephone_number": "920-288-8250",
"fax_number": "920-288-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 GREENBRIER RD STE 230",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543116519",
"telephone_number": "920-288-8250",
"fax_number": "920-288-8255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERAS",
"first_name": "PER",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-18",
"last_updated": "2008-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "24450",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30548500",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "020040912",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104082668",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.