Individual provider Active NPI

Daniel Pantzlaff, H.I.S.

  • Hearing Instrument Specialist
  • Green Bay, WI
National Provider Identifier
1902006059
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1239-060 Issued in WI
Practice address
2733 Manitowoc Rd Ste 8B
Green Bay, WI 54311-4901
Phone
(920) 468-7474
NPI assigned
Jul 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 1239-060 WI Primary

Addresses

Primary practice location

2733 Manitowoc Rd Ste 8B
Green Bay, WI 54311-4901

Mailing address

2733 Manitowoc Rd Ste 8B
Green Bay, WI 54311-4901
Phone (920) 468-7474

Other identifiers 1

IdentifierTypeStateIssuer
42837600MedicaidWI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1239-060WIMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
All About Hearing Service LLC 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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1902006059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 MANITOWOC RD STE 8B",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114901",
            "telephone_number": "920-468-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2733 MANITOWOC RD STE 8B",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114901",
            "telephone_number": "920-468-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTZLAFF",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "H.I.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WI",
            "license": "1239-060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42837600",
            "state": "WI"
        }
    ],
    "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 Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.