Individual provider Active NPI

Gina Pietras Spohn, MD

  • Dermatology Physician
  • Green Bay, WI
National Provider Identifier
1952729774
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
83317-20 Issued in WI
Practice address
2806 Riverview Dr
Green Bay, WI 54313-6717
Phone
(920) 498-7546
Fax
(920) 569-4129
NPI assigned
Mar 29, 2014
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 83317-20 WI Primary

Addresses

Primary practice location

2806 Riverview Dr
Green Bay, WI 54313-6717

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

835 S Main St Ste 1
Oconto Falls, WI 54154-1282
Phone (920) 846-4864

Other practice location 2

N4531 State Highway 22 Ste 5
Shawano, WI 54166-6173
Phone (715) 524-5995

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address Gina.Spohn@forefrontdermatology.emadirect.md
Direct Messaging Address Gina.Spohn@forefrontdermatology.emadirect.md
Direct Messaging Address Gina.Spohn@forefrontdermatology.emadirect.md

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
I20240307003442 WI Practitioner - Dermatology 8123349032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Ohio State University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

2806 Riverview Dr
Green Bay, WI 54313-6717
Phone (920) 498-7546

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision85
Removal of skin lesions555
Skin biopsy165

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83317-20WIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. Dermatology CurrentSince Feb 23, 2024 Accepting new patients
Forefront Dermatology, S.C. Dermatology Current Accepting new patients
Forefront Dermatology, S.C. Dermatology CurrentSince Feb 23, 2024 Accepting new patients
Forefront Dermatology, S.C. Dermatology PastSince Aug 25, 2024 Accepting new patients
Forefront Dermatology, S.C. Dermatology Past Accepting new patients

Locations

1400 Scheuring Rd
De Pere, WI 54115
Phone (920) 964-0229

2806 Riverview Dr
Green Bay, WI 54313
Phone (920) 498-7546

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

835 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-4864

N4531 State Highway 22
Ste 5
Shawano, WI 54166
Phone (715) 524-5995

Interoperability endpoints

  • Direct secure messaging: gspohn@directaddress.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1952729774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 RIVERVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543136717",
            "telephone_number": "920-498-7546",
            "fax_number": "920-569-4129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 S Main St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Oconto Falls",
            "state": "WI",
            "postal_code": "541541282",
            "country_code": "US",
            "telephone_number": "920-846-4864",
            "fax_number": "920-846-2073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N4531 State Highway 22 Ste 5",
            "address_purpose": "LOCATION",
            "city": "Shawano",
            "state": "WI",
            "postal_code": "541666173",
            "country_code": "US",
            "telephone_number": "715-524-5995",
            "fax_number": "715-953-4257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPOHN",
        "first_name": "GINA",
        "middle_name": "PIETRAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "83317-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Gina.Spohn@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2806 Riverview Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543136717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Gina.Spohn@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "835 S Main St Ste 1",
            "city": "Oconto Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541541282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Gina.Spohn@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "N4531 State Highway 22 Ste 5",
            "city": "Shawano",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541666173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.