THE NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN SC (NPI# 1578516803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578516803 |
| Entity Type | Organization |
| Organization Name | THE NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN SC |
| Other Organization Name | NEUROSCIENCE GROUP |
| Practice Address |
1305 W. American Drive Neenah WI 54956-1993 |
| Mailing Address |
1305 W American Drive Neenah WI 54956-1993 |
| Practice Telephone | 8002011194 |
| Practice Fax Number | 9207207392 |
| Mailing Telephone | 8002011194 |
| Mailing Fax Number | 9207207392 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-08-16 |
| Authorized Official Name | PHILIP YAZBAK (PRESIDENT) |
| Authorized Official Telephone | 8002011194 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 21284100 | 05 | |
| WI | MEDICARE | 000071450 | 01 |
| RAILROAD MEDICARE | CD3987 | 01 |
| Other Name | Type Code |
|---|---|
| Neuroscience Group | Doing Business As Name - Organization |
| Street Address |
1305 W. AMERICAN DRIVE |
| City | NEENAH |
| State | WI |
| Zip Code | 54956-1993 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710938899 | Cathy Diane Shine | Nurse Practitioner | 1305 W. American Drive, Neenah, WI 54956-2883 | 2006-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447768411 | Wisconsin Institute of Surgical Excellence LLC | Clinic/Center | 1265 W American Dr Ste 200, Neenah, WI 54956 | 2018-01-12 |
| 1639614290 | Clinton Robert Murchland | Pharmacist | 828 Fox Point Plaza, Pharmacy, Neenah, WI 54956 | 2017-01-05 |
| 1629448550 | Melissa Christine Hewitt | Physical Therapy Assistant | 1119 Higgins Ave, Neenah, WI 54956 | 2015-10-05 |
| 1437581923 | Ross Phan | Pharmacist | 1432 Seymour Crt, Neenah, WI 54956 | 2013-08-06 |
| 1518201318 | Meridith Nealy Starling | Social Worker | 124 W Wisconsin Ave, Suite 90 B, Neenah, WI 54956 | 2012-11-16 |
| 1639464886 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 901 S. Green Bay Rd, Neenah, WI 54956 | 2011-06-16 |
| 1669701439 | Donna Jean Falk | Licensed Practical Nurse | 1037 B Hunt Ave, Neenah, WI 54956 | 2009-12-08 |
| 1285868257 | Angela Marie Bilbrey | Dietitian, Registered | 307 S Commercial St Ste 101, Neenah, WI 54956 | 2009-05-06 |
| 1003083114 | A B See Vision Therapy Centers Sc | Optometrist | 1401 Mcmahon Dr., Suite 100, Neenah, WI 54956 | 2008-05-08 |
| 1629244173 | Tamra Marie Knutson | Radiology | 333 N Commercial St #100, Neenah, WI 54956 | 2008-05-05 |
| Find all providers in zip 54956 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619070802 | Alexander Todd Hawkins | Neurological Surgery | 1305 W American Dr, Neenah, WI 54956-1993 | 2006-09-06 |
| 1447293188 | Randall Roy Johnson | Neurological Surgery | 1305 W American Dr, Neenah, WI 54956-1993 | 2006-06-13 |
| 1245272442 | Thomas Alston Lyons | Neurological Surgery | West Pavillon 2nd Floor 130 2nd Street, The Neuroscience Group of Ne Wi, Neenah, WI 54956-2883 | 2006-06-12 |
| 1740221910 | Sumon Bhattacharjee | Neurological Surgery | 1305 W American Dr, Neenah, WI 54956-1993 | 2006-06-09 |
| 1538119649 | Philip Andrew Yazbak | Neurological Surgery | 1305 W American Dr, Neenah, WI 54956-1993 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528350436 | Craig R Kelman | Neurological Surgery | 425 Pine Ridge Blvd Ste 300, Wausau, WI 54401 | 2011-05-11 |
| 1952545014 | Irene Kim | Neurological Surgery | 999 N 92nd St Ste 310, Milwaukee, WI 53226-4875 | 2009-04-20 |
| 1649419169 | Walter P Jacobsen | Neurological Surgery | 2801 W Kinnickinnic River Pkwy Ste 680, Milwaukee, WI 53215-3669 | 2009-02-05 |
| 1538324793 | Jose Luis Salazar | Neurological Surgery | 3220 N Shore Dr, Delavan, WI 53115-3800 | 2008-07-26 |
| 1205094711 | Bruce Clarke Bressler | Neurological Surgery | 3117 Bay View Dr, Green Bay, WI 54311-5909 | 2008-05-30 |
| 1154506921 | Werner E Langheim | Neurological Surgery | 4505 Fox Bluff Lane, Middleton, WI 53562-2327 | 2007-12-29 |
| 1427251339 | Pedro Daniel Suberviola | Neurological Surgery | 3255 Yale Ct, Brookfield, WI 53005-2772 | 2007-06-07 |
| 1831212778 | Allan Bertram Levin | Neurological Surgery | 4585 Fox Bluff Ln, Middleton, WI 53562-2327 | 2007-04-07 |
| 1013093178 | Cully R White | Neurological Surgery | 2901 W Kinnickinnic River Parkway, Suite 201, Milwaukee, WI 53215 | 2006-10-31 |
| 1538269402 | Christopher I. Mackay | Neurological Surgery | 2800 Westhill Dr., Suite 200, Wausau, WI 54407-3770 | 2006-09-22 |
| 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.