NPIMap

Individual provider Active NPI

John Ganser, DO

  • Family Medicine Physician
  • Appleton, WI
National Provider Identifier
1922035658
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38921 Issued in WI
Practice address
2809 N Park Drive LN
Appleton, WI 54911-1603
Phone
(920) 738-4600
Fax
(920) 738-4792
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38921 WI Primary

Addresses

Primary practice location

2809 N Park Drive LN
Appleton, WI 54911-1603

Mailing address

PO Box 8003
Appleton, WI 54912-8003
Phone (920) 996-3298

Other identifiers 1

IdentifierTypeStateIssuer
30084200MedicaidWI

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
I20100223000852 WI Practitioner - Family Practice 0244374635 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

1818 N Meade St
Appleton, WI 54911-3454

1818 N Meade St Room
N255
Appleton, WI 54911-3454
Phone (920) 730-3383

2500 E Capital Dr
Appleton, WI 54911-8735

3 Neenah Ctr
Neenah, WI 54956-3070

3925 N Gateway Dr
Appleton, WI 54913-7863
Phone (820) 702-6477

4480 W Spencer St
Appleton, WI 54915
Phone (920) 738-4800

670 Country Rd a
Green Lake, WI 54941-8608
Phone (920) 294-0100

900 E Grant St
Thedacare Orthopedic Care
Appleton, WI 54911-3454
Phone (920) 831-5050

W5282 Amy Ave
Appleton, WI 54915-7233
Phone (920) 358-1900

Hospital & facility affiliations

  • Thedacare at Home Hospice, Appleton, WI, CCN 521504
  • Thedacare Regional Medical Center - Appleton Inc Hospital, Appleton, WI, CCN 520160
  • Thedacare Regional Med Ctr - Neenah Hospital, Neenah, WI, CCN 520045

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38921WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated Family Medicine CurrentSince Aug 1, 1999 Accepting new patients
Thedacare Medical Center - Berlin, Inc. Past Accepting new patients

Locations

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

2500 E Capitol Dr
Appleton, WI 54911
Phone (920) 738-4600

1010 S Oneida St
Appleton, WI 54915
Phone (920) 733-7726

2809 N Park Drive Ln
Appleton, WI 54911
Phone (920) 380-4999

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

Interoperability endpoints

  • Direct secure messaging: jganser10523@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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922035658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3298",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 N PARK DRIVE LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111603",
            "telephone_number": "920-738-4600",
            "fax_number": "920-738-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSER",
        "first_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "38921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30084200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.