Sarah Elisabeth Baumgartner, PHD
Individual provider Active NPI Psychologist · Green Bay, WI
NPI 1992086748 · NPPES record last updated Aug 12, 2022
Key facts
- NPI
- 1992086748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 3670-57 (WI)
- Practice address
- 301 E Saint Joseph St
Green Bay, WI 54301-2241 - Phone
- (920) 433-6073
- Fax
- (920) 431-0333
- NPI assigned
- Sep 7, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Bellin Memorial Hospital Inc
Practice addresses (Care Compare)
933 Waube LN
Green Bay, WI 54304-5521
Phone (920) 548-9500
Hospital & facility affiliations
- Bellin Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190628000414 | WI | Practitioner - Clinical Psychologist | 5395079115 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3670-57 | WI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Psychiatric Center Inc | Current |
Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current |
Accepting new patients | |
| Bellin Memorial Hospital Inc | Current |
Accepting new patients | |
| Bellin Psychiatric Center Inc. | Psychologist | Current |
Accepting new patients |
| Bellin Psychiatric Center Inc | Current | Accepting new patients |
Locations
933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3670-57 | WI | Yes |
Addresses
Primary practice location
301 E Saint Joseph St
Green Bay, WI 54301-2241
Mailing address
PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7222
Other names
- Sarah Elisabeth Ellefson
NPI Registry JSON
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1992086748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22040",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052040",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E SAINT JOSEPH ST",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543012241",
"telephone_number": "920-433-6073",
"fax_number": "920-431-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMGARTNER",
"first_name": "SARAH",
"middle_name": "ELISABETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-07",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "3670-57",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARAH",
"last_name": "ELLEFSON",
"middle_name": "ELISABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.