Individual provider Active NPI

David Milo Hirschi III, MD

  • Sports Medicine (Family Medicine) Physician
  • Appleton, WI
National Provider Identifier
1891109039
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
72217 Issued in WI
Practice address
820 E Grant St
Appleton, WI 54911
Phone
(920) 831-5050
Fax
(920) 738-6400
NPI assigned
Jun 16, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 72217 WI Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 01080150A IN
Family Medicine Physician 207Q00000X MRM-1386 ID

Addresses

Primary practice location

820 E Grant St
Appleton, WI 54911

Mailing address

3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 454-8208

Other practice location 1

515 Read St
Evansville, IN 47710
Phone (812) 424-9291

Other practice location 2

515 Read St
Evansville, IN 47710
Phone (812) 424-9291

Other practice location 3

10455 Orthopaedic Dr
Newburgh, IN 47630-7955
Phone (812) 424-9291

Other practice location 4

5828 Pearl Dr
Evansville, IN 47712-8116
Phone (812) 424-9291

Other practice location 5

4011 Gateway Blvd Ste 100
Newburgh, IN 47630-8947
Phone (812) 424-9291

Other practice location 6

191 Memorial Dr Ste 100
Berlin, WI 54923-1241
Phone (920) 361-2500

Other identifiers 1

IdentifierTypeStateIssuer
000001175249OtherINANTHEM BCBS

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
I20191125000247 WI Practitioner - Sports Medicine 7719104926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

820 E Grant St
Appleton, WI 54911-3483
Phone (920) 831-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MRM-1386IDMDFamily Medicine Physician
72217WIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated Family Medicine CurrentSince Nov 18, 2019 Accepting new patients
Thedacare, Incorporated CurrentSince Nov 18, 2019 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

2400 E Capitol Dr
Appleton, WI 54911
Phone (920) 731-4101

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

122 E College Ave
Appleton, WI 54911
Phone (920) 996-3264

191 Memorial Dr
Ste 100
Berlin, WI 54923
Phone (920) 361-2500

191 Memorial Dr
Ste 200
Berlin, WI 54923
Phone (920) 361-6330

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

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

Interoperability endpoints

  • Direct secure messaging: dhirschi281418@direct.thedacare.org

Organizations & group practices 3

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 12

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": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1891109039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 NEENAH CTR",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563070",
            "telephone_number": "920-454-8208",
            "fax_number": "920-993-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E GRANT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54911",
            "telephone_number": "920-831-5050",
            "fax_number": "920-738-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 Read St",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "47710",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Read St",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "47710",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10455 Orthopaedic Dr",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307955",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5828 Pearl Dr",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477128116",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4011 Gateway Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476308947",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "191 Memorial Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "WI",
            "postal_code": "549231241",
            "country_code": "US",
            "telephone_number": "920-361-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HIRSCHI",
        "first_name": "DAVID",
        "middle_name": "MILO",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-16",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "72217",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "01080150A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRM-1386",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000001175249",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.