Individual provider Active NPI

Sarah Elisabeth Baumgartner, PHD

  • Psychologist
  • Green Bay, WI
National Provider Identifier
1992086748
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3670-57 Issued in 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
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3670-57 WI Primary

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 1

  • Sarah Elisabeth Ellefson Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190628000414 WI Practitioner - Clinical Psychologist 5395079115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

933 Waube LN
Green Bay, WI 54304-5521
Phone (920) 548-9500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Jan 1, 2025 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jan 1, 2025 Accepting new patients
Bellin Psychiatric Center Inc CurrentSince Jul 15, 2019 Accepting new patients
Bellin Psychiatric Center Inc. Psychologist CurrentSince Jul 15, 2019 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Psychiatric Center Inc Current Accepting new patients

Locations

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

933 Waube Ln
Green Bay, WI 54304
Phone (920) 548-9500

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 1

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": "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

Verify at the official NPI Registry.