Individual provider Active NPI

Holly L Haberman, MD

  • Family Medicine Physician
  • Waupaca, WI
National Provider Identifier
1922457803
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74008 Issued in WI
Practice address
710 Riverside Dr
Waupaca, WI 54981-1941
Phone
(715) 256-3000
Fax
(715) 256-3039
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 74008 WI
Obstetrics Physician 207VX0000X 74008 WI
Family Medicine Physician 207Q00000X 74008 WI Primary

Addresses

Primary practice location

710 Riverside Dr
Waupaca, WI 54981-1941

Mailing address

710 Riverside Dr
Waupaca, WI 54981-1941
Phone (715) 256-3000

Other practice location 1

1600 23rd Ave
Greeley, CO 80634-6070
Phone (970) 810-2424

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
I20201002002553 WI Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 3072842301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

608 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74008WIMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc Family Medicine CurrentSince Sep 1, 2025 Accepting new patients
Thedacare, Incorporated Family Medicine CurrentSince Aug 25, 2021 Accepting new patients
Agnesian Healthcare Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

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

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

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

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

710 Riverside Dr
Waupaca, WI 54981
Phone (715) 256-3000

608 W Brown St
Waupun, WI 53963
Phone (920) 324-6800

Interoperability endpoints

  • Direct secure messaging: hhaberman555667@direct-ehr-ssmhc.com
  • Direct secure messaging: hhaberman297414@direct.thedacare.org

Organizations & group practices 4

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 5

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": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1922457803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811941",
            "telephone_number": "715-256-3000",
            "fax_number": "715-256-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 RIVERSIDE DR",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549811941",
            "telephone_number": "715-256-3000",
            "fax_number": "715-256-3039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 23rd Ave",
            "address_purpose": "LOCATION",
            "city": "Greeley",
            "state": "CO",
            "postal_code": "806346070",
            "country_code": "US",
            "telephone_number": "970-810-2424",
            "fax_number": "970-810-2774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABERMAN",
        "first_name": "HOLLY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WI",
            "license": "74008",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WI",
            "license": "74008",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "74008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupaca, WI

Sources for this page

Verify at the official NPI Registry.