Active NPI
Victoria Passov, MD
- Psychiatry Physician
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 59847-20
- Practice address
- 301 E Saint Joseph St
Green Bay, WI 54301-2241 - Phone
- (920) 433-6073
- Fax
- (920) 431-0333
- NPI assigned
- Feb 15, 2007
- Last updated
- Nov 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 49830 | MN | |
| Psychiatry Physician | 2084P0800X | 59847-20 | WI | Primary |
Addresses
Primary practice location
301 E Saint Joseph St
Green Bay, WI 54301-2241
Mailing address
PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7222
Other practice location 1
200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043445000 | Medicaid | MN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
744 S Webster Ave
Green Bay, WI 54301-3505
Phone (920) 433-6025
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49830 | MN | MD | Psychiatry Physician |
| 59847-20 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Psychiatric Center Inc | Psychiatry | Current | Accepting new patients |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Psychiatric Center Inc. | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| SBH-Green Bay LLC | Psychiatry | Current | Accepting new patients |
| Bellin Psychiatric Center Inc | Psychiatry | Current | Accepting new patients |
| Mayo Clinic | Past | Accepting new patients |
Locations
1351 Ontario Rd
Green Bay, WI 54311
Phone (920) 328-1220
2305 San Luis Pl
Green Bay, WI 54304
Phone (920) 494-2817
301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
Interoperability endpoints
- vpassov201356@direct.thedacare.org
- vpassovadams925129@direct.emplifyhealth.org
Organizations & group practices 8
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.
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba Bellin Behavior Health Bellevue Inc
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Green Bay, WI
- NPI 1952554800
Psychiatry
-
dba Willow Creek Behavioral Health
- Psychiatric Hospital
- Green Bay, WI
- NPI 1922556778
Psychiatry
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
-
dba Bellin Health Generations
- Clinic/Center
- Green Bay, WI
- NPI 1497191951
-
dba Bellin Behavior Health Algoma
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Algoma, WI
- NPI 1124438478
Psychiatry
-
dba Bellin Behavioral Health
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Green Bay, WI
- NPI 1598728776
-
- Clinical Medical Laboratory
- Rochester, MN
- NPI 1083249577
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1891740585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606089600000",
"number": "1891838173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22040",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052040",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E SAINT JOSEPH ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012241",
"telephone_number": "920-433-6073",
"fax_number": "920-431-0333"
}
],
"practiceLocations": [
{
"address_1": "200 1st St SW",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "MN",
"postal_code": "559050001",
"country_code": "US",
"telephone_number": "507-284-2511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PASSOV",
"first_name": "VICTORIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2020-11-23",
"certification_date": "2020-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "49830",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "59847-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043445000",
"state": "MN"
}
],
"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 Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.