DR. MATTHEW EDWARD BETTAG (NPI# 1487646675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487646675 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW EDWARD BETTAG |
| Credential | M.D. |
| Practice Address |
1520 N Meade St Appleton WI 54911-3762 |
| Mailing Address |
2424 Trefoil Ct Menasha WI 54952-8922 |
| Practice Telephone | 9207347181 |
| Practice Fax Number | 9207340621 |
| Mailing Telephone | 9209545624 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2012-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 44145 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34184900 | 05 |
| Street Address |
1520 N MEADE ST |
| City | APPLETON |
| State | WI |
| Zip Code | 54911-3762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407055528 | Jacqueline Nicole Maxam | Audiologist | 1520 N Meade St, Appleton, WI 54911-3762 | 2007-07-18 |
| 1629294145 | Michael James Mcavoy | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2007-04-17 |
| 1699791285 | Heather L Totman | Audiologist-Hearing Aid Fitter | 1520 N Meade St, Appleton, WI 54911-3762 | 2006-07-15 |
| 1629094214 | Ear Nose & Throat Surgical Associates Sc | Specialist | 1520 N Meade St, Appleton, WI 54911-3762 | 2006-07-15 |
| 1457343642 | Mitchell Francis Kwaterski | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1295727345 | Steven James Vandenberg | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1801888011 | Kent Carlton Schaefer | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1508858721 | Kristin K Borgen | Audiologist | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1659363877 | Jessica M Jenkins-werner | Audiologist | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912545633 | Brotherly Love, LLC | Day Training, Developmentally Disabled Services | 1513 E Frances St, Appleton, WI 54911 | 2019-12-12 |
| 1952952129 | Eagle Point Senior Living Inc | Assisted Living Facility | 995 East John Street, Appleton, WI 54911 | 2019-09-27 |
| 1619524766 | University Rx LLC | Pharmacy | 133 E College Ave, Appleton, WI 54911 | 2019-08-23 |
| 1174080063 | Shayla Russell | Counselor | Outagamie County Health and Human Services, 320 S. Walnut St., Appleton, WI 54911 | 2019-02-27 |
| 1871086645 | Megan Kilsdonk | Health Educator | 1604 N Meade St, Appleton, WI 54911 | 2018-06-07 |
| 1871085480 | Tanya Lynn Vickery | Social Worker | 410 S. Elm St., Appleton, WI 54911 | 2018-05-31 |
| 1013407501 | Teri G Metropulos | Counselor | 229 S. Morrison, Appleton, WI 54911 | 2018-05-10 |
| 1093211211 | Bonnie Anne Korytkowski | Student in an Organized Health Care Education/Training Program | 229 S. Morrison Street, Appleton, WI 54911 | 2018-04-05 |
| 1639673940 | Brett Follett | Psychologist | 401 S. Elm St., Appleton, WI 54911 | 2018-03-21 |
| 1700202892 | Brian Withrow | Counselor | 607 West 7th St., Appleton, WI 54911 | 2014-03-13 |
| Find all providers in zip 54911 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619945938 | Darin L Wright | Otolaryngology | 1501 S Madison St, Appleton, WI 54915-1846 | 2006-03-11 |
| 1710971783 | Gregory J Swanson | Otolaryngology | 1501 S Madison St, Appleton, WI 54915-1846 | 2005-09-07 |
| 1457343642 | Mitchell Francis Kwaterski | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1295727345 | Steven James Vandenberg | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| 1801888011 | Kent Carlton Schaefer | Otolaryngology | 1520 N Meade St, Appleton, WI 54911-3762 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972104156 | Alliance Ent and Hearing Center, Sc | Otolaryngology | 2524 E Webster Place, Suite 201, Milwaukee, WI 53211-4257 | 2020-11-04 |
| 1962969915 | Alliance Ent & Hearing Center, S.c. | Otolaryngology | 2500 W Layton Ave Ste 230, Milwaukee, WI 53221-5421 | 2019-02-26 |
| 1851822076 | Fort Health Care Inc | Otolaryngology | 123 Hospital Dr Suite 106a, Watertown, WI 53098 | 2017-03-21 |
| 1184010977 | Chad Michael Ennis | Otolaryngology | 1 S Park St Fl 6, Madison, WI 53715-1375 | 2015-04-08 |
| 1487055133 | Sam Khalili | Otolaryngology | 2801 W Kinnickinnic River Pkwy # 680, Milwaukee, WI 53215 | 2014-09-12 |
| 1760803795 | Gary Miller | Otolaryngology | 3467 Northwood Rd, Suamico, WI 54313-8250 | 2013-12-17 |
| 1629320007 | Peter Uy Lee | Otolaryngology | 1341 Boundary Rd, Middleton, WI 53562-3843 | 2012-10-09 |
| 1700145091 | Kenneth Brian Lewoczko | Otolaryngology | 600 Highland Ave., H4/831, Uw Hospital and Clinics, Madison, WI 53792 | 2012-05-08 |
| 1962768267 | Christopher Joseph Lee | Otolaryngology | 500 W. Drexel Ave, Suite 300, Oak Creek, WI 53154-2060 | 2012-04-11 |
| 1871814715 | Norval Eldred Bernhardt | Otolaryngology | 9 Holt Ct, Madison, WI 53719-3036 | 2010-06-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.