Ethan T Shaver (NPI# 1013452002, PAC ID# 8527341924) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1013452002 |
| PAC ID by PECOS | 8527341924 |
| Professional Enrollment ID | I20170209000740 |
| Full Name | Ethan T Shaver |
| Organization Legal Name | BAYCARE CLINIC LLP |
| Address |
1346 E Green Bay St Shawano WI 54166-2210 |
| Phone Number | 7155266244 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4385554328 |
| Number of Group Practice Members | 172 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520193 | AURORA BAYCARE MEDICAL CENTER |
| 520034 | AURORA MEDICAL CTR MANITOWOC COUNTY |
| Address | Phone | Organization |
|---|---|---|
| 1160 Kepler Dr, Green Bay, WI 54311-8321 | 9202885555 | BAYCARE CLINIC LLP |
| 2845 Greenbrier Rd, Green Bay, WI 54311-6519 | BAYCARE CLINIC LLP | |
| 1346 E Green Bay St, Shawano, WI 54166-2210 | 7155266244 | BAYCARE CLINIC LLP |
| Organization Legal Name | BAYCARE CLINIC LLP |
| Physicians | 170 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan R Woods | Orthopedic Surgery | Baycare Clinic LLP | 1160 Kepler Dr, Green Bay, WI 54311-8321 |
| Lacey L Jandrin | Physician Assistant | Baycare Clinic LLP | 501 N 10th St, Manitowoc, WI 54220-4039 |
| Chad R Seubert | Oral Surgery | Baycare Clinic LLP | 2581 Development Dr, Green Bay, WI 54311-4246 |
| Madeline C Almond | Ophthalmology | Baycare Clinic LLP | 2140 Velp Ave, Green Bay, WI 54303-6492 |
| Kevin Pa Wienkers | Ophthalmology | Baycare Clinic LLP | 30 N 18th Ave Bldg, Suite 6, Sturgeon Bay, WI 54235-3207 |
| Ashley M Spindler | Physician Assistant | Baycare Clinic LLP | 4061 Old Peshtigo Rd, Marinette, WI 54143-3887 |
| Brian E Bozelka | Ophthalmology | Baycare Clinic LLP | 1400 University Dr, Marinette, WI 54143-5105 |
| Brad J Lavallie | Optometry | Baycare Clinic LLP | 323 E Highland Dr, Suite 8, Oconto Falls, WI 54154-1006 |
| Benjamin E Phillips | Ophthalmology | Baycare Clinic LLP | 4801 Expo Dr, Manitowoc, WI 54220-9341 |
| Thomas J Wilkins | Physical Medicine and Rehabilitation | Baycare Clinic LLP | 2401 Holmgren Way, Green Bay, WI 54304-5224 |
| Street Address |
1346 E GREEN BAY ST |
| City | SHAWANO |
| State | WI |
| Zip | 54166-2210 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard D Sarnwick | Family Medicine | Aurora Medical Group Inc | 1346 E Green Bay St, Shawano, WI 54166-2210 |
| Scott T Weslow | Cardiovascular Disease (cardiology) | Baycare Aurora, LLC | 1346 E Green Bay St, Shawano, WI 54166-2210 |
| Tod C Lewis | Family Medicine | Aurora Medical Group Inc | 1346 E Green Bay St, Shawano, WI 54166-2210 |
| Jill M Witte | Nurse Practitioner | Aurora Medical Group Inc | 1346 E Green Bay St, Shawano, WI 54166-2210 |
| Jessica L Sigl | Physical Therapy | Baycare Aurora, LLC | 1346 E Green Bay St, Shawano, WI 54166-2210 |
| Angela K Gutche | Nurse Practitioner | Aurora Medical Group Inc | 1346 E Green Bay St, Shawano, WI 54166-2210 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy K Wondra | Clinical Social Worker | County of Shawano | W7327 Anderson Ave, Shawano, WI 54166-1143 |
| Robert G Brucker | Diagnostic Radiology | Radiology Associates of Appleton Sc | 309 N Bartlette St, Shawano, WI 54166-2127 |
| Thomas P Wargo | Chiropractic | Stockbridge Munsee Community | 309 N Bartlett St, Shawano, WI 54166-2127 |
| Sarah L Konzak | Occupational Therapy | Aurora Medical Group Inc | 309 N Bartlett St, Shawano, WI 54166-2127 |
| John E Sowin | Diagnostic Radiology | Radiology Associates of Appleton Sc | 309 N Bartlette St, Shawano, WI 54166-2127 |
| Janson A Mancheski | Optometry | 1244 E Greenbay St, Shawano, WI 54166-2208 | |
| Jeffry J Young | Pediatric Medicine | St Vincent Hospital-hospital Sisters-third Order of St Francis | 1300 E Green Bay St, Shawano, WI 54166-2210 |
| Heidi Marie Bruckert | Nurse Practitioner | St Vincent Hospital-hospital Sisters-third Order of St Francis | 1300 E Green Bay St, Shawano, WI 54166-2210 |
| Leah K Smejkal | Physical Therapy | Orthopedic and Spine Therapy of Clintonville, Sc | 205 W Green Bay St, Shawano, WI 54166-2333 |
| Alexander J Reget | Physical Therapy | Orthopedic and Spine Therapy of Clintonville, Sc | 205 W Green Bay St, Shawano, WI 54166-2333 |
| Find all physicians in zip 54166 | |||
| City | SHAWANO |
| Zip Code | 54166 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SHAWANO + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.