NPIMap

Individual provider Active NPI

Ciprian Nedelcu, M.D.

  • Cardiovascular Disease Physician
  • Green Bay, WI
National Provider Identifier
1932134970
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
64729 Issued in WI
Practice address
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone
(920) 288-8300
Fax
(920) 288-8305
NPI assigned
Jul 11, 2006
Last updated
Jan 21, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 231375 NY
Cardiovascular Disease Physician 207RC0000X 64729 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd
Green Bay, WI 54311-6519

Mailing address

164 N Broadway
Green Bay, WI 54303-2728
Phone (920) 288-8300

Other identifiers 1

IdentifierTypeStateIssuer
100049786MedicaidWI

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
I20151208002335 WI Practitioner - Cardiovascular Disease (Cardiology) 5395835060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Aurora LLCGroup PAC ID 0244130557, 197 clinicians

Practice addresses (Care Compare)

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64729WIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Aurora, LLC Cardiovascular Disease CurrentSince Dec 1, 2015 Accepting new patients
The Brooklyn Hospital Center Cardiovascular Disease Past Accepting new patients
The Brooklyn Hospital Center Past Accepting new patients
Caledonian Health Center Past Accepting new patients
TBHC Pediatric Services PC PastSince Jan 1, 2016 Accepting new patients
Lafayette Medical Office, PC PastSince Oct 6, 2009 Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

3003 University Dr
Marinette, WI 54143
Phone (715) 732-8200

1136 Westowne Dr
Neenah, WI 54956
Phone (920) 456-2030

5300 Memorial Dr
Two Rivers, WI 54241
Phone (920) 793-7300

Interoperability endpoints

  • Direct secure messaging: cnedelcu169030@direct.myadvocateaurora.org

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1932134970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 N BROADWAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032728",
            "telephone_number": "920-288-8300",
            "fax_number": "920-288-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8300",
            "fax_number": "920-288-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEDELCU",
        "first_name": "CIPRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "231375",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WI",
            "license": "64729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100049786",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.