D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC – NPI #1093096224
Surgery

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC is a surgeon located in GREEN BAY, WI. NPPES has assigned the NPI number 1093096224 to D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC on September 01, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC” is a dba name, the actual legal business name for this organization is COMMUNITY MEMORIAL HOSPITAL, INCORPORATED. The primary taxonomy selected by this provider is 208600000X from the Health Care Provider Taxonomy code set, which is classified as Surgery.

The NPI profile was previously updated about 14 years ago on Jan 13, 2012. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC below.

NPI Profile for
COMMUNITY MEMORIAL HOSPITAL, INCORPORATED

NPI Number
1093096224
Enumeration Date

(about 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COMMUNITY MEMORIAL HOSPITAL, INCORPORATED
Doing Business As (dba): D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC
Primary location
1726 SHAWANO AVE
GREEN BAY, WI 54303-3216
Phone: (920) 360-3787 Fax: (888) 848-0225
Mailing address
25630 NETWORK PL
CHICAGO, IL 60673-1256
Phone: (920) 360-3787 Fax: (888) 848-0225
Organization Subpart
Yes - D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC is subpart of another organization.
Authorized Official
DANIEL DEGROOT
CEO
Phone: (920) 846-3444
Updated
Identifiers

Identifiers for D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERCMH NPIWI1851477913
OTHERMEDICARE PTANWIWI2552
OTHERPROVIDERWI1750302089
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208600000X
- Surgery (Primary)
WI 39597-20

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.