Individual provider Active NPI

Seth L McIntire, DO

  • Psychiatry Physician
  • Neenah, WI
National Provider Identifier
1891255857
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
81176 Issued in WI
Practice address
130 2ND St
Neenah, WI 54956-2883
Phone
(920) 720-2300
Fax
(920) 720-3719
NPI assigned
Mar 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 81176 WI Primary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 34.014729 OH

Addresses

Primary practice location

130 2ND St
Neenah, WI 54956-2883

Mailing address

1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-2300

Other practice location 1

455 Shawnee Ln
Chillicothe, OH 45601-4145
Phone (740) 779-4888

Other practice location 2

580 Park Ave W
Mansfield, OH 44906-3722
Phone (833) 510-4357

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
I20230726001522 WI Practitioner - Psychiatry 3072840156 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Jul 12, 2023 Accepting new patients
Thedacare, Incorporated CurrentSince Jul 12, 2023 Accepting new patients

Locations

1095 Midway Rd
Menasha, WI 54952
Phone (920) 720-3700

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

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

Interoperability endpoints

  • Direct secure messaging: smcintire332492@direct.thedacare.org

Organizations & group practices 2

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1891255857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-720-2300",
            "fax_number": "920-729-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 2ND ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562883",
            "telephone_number": "920-720-2300",
            "fax_number": "920-720-3719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Shawnee Ln",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456014145",
            "country_code": "US",
            "telephone_number": "740-779-4888",
            "fax_number": "740-779-4898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "580 Park Ave W",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063722",
            "country_code": "US",
            "telephone_number": "833-510-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "SETH",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-24",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "81176",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "34.014729",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.