NPIMap

Individual provider Active NPI

Raymond Frank Georgen, M.D.

  • Surgery Physician
  • Neenah, WI
National Provider Identifier
1912957457
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
309901 Issued in WI
Practice address
200 Theda Clark Medical PLZ
Suite 410
Neenah, WI 54956-2721
Phone
(920) 725-4527
Fax
(920) 725-0991
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 309901 WI Primary

Addresses

Primary practice location

200 Theda Clark Medical PLZ
Suite 410
Neenah, WI 54956-2721

Mailing address

200 Theda Clark Medical PLZ
Suite 410
Neenah, WI 54956-2721
Phone (920) 725-4527

Other identifiers 1

IdentifierTypeStateIssuer
31596300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120117000402 WI Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology)Practitioner - Thoracic SurgeryPractitioner - Vascular SurgeryPractitioner - Surgical Oncology 5496668576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology), Surgical Oncology, Thoracic Surgery, Vascular Surgery
Education
Loyola University of Chicago, Stritch School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Associates of Neenah, S.C.Group PAC ID 4486625258, 29 clinicians

Practice addresses (Care Compare)

100 Theda Clark Medical PLZ
Suite 400
Neenah, WI 54956-2763
Phone (920) 725-4527

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy27
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux43
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309901WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Associates of Neenah, S.C. Surgery CurrentSince Aug 1, 1992 Accepting new patients

Locations

200 Theda Clark Medical Plz
Ste 410
Neenah, WI 54956
Phone (920) 725-4527

100 Theda Clark Medical Plz
Neenah, WI 54956
Phone (920) 722-7747

100 Theda Clark Medical Plz
Ste 400
Neenah, WI 54956
Phone (414) 725-4527

Interoperability endpoints

  • Direct secure messaging: rgeorgen22078@direct.thedacare.org
  • Direct secure messaging: rgeorgen865418@direct.froedtert.com

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.

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1912957457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ",
            "address_2": "SUITE 410",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562721",
            "telephone_number": "920-725-4527",
            "fax_number": "920-725-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 THEDA CLARK MEDICAL PLZ",
            "address_2": "SUITE 410",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549562721",
            "telephone_number": "920-725-4527",
            "fax_number": "920-725-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGEN",
        "first_name": "RAYMOND",
        "middle_name": "FRANK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "309901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31596300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.