DR. ROBERT PERZACKI (NPI# 1396761276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396761276 |
| Entity Type | Individual |
| Full Name | DR. ROBERT PERZACKI |
| Credential | M.D. |
| Practice Address |
1820 Appleton Rd Menasha WI 54952-1110 |
| Practice Telephone | 9209962200 |
| Practice Fax Number | 9209962214 |
| Mailing Telephone | 9209962200 |
| Mailing Fax Number | 9209962214 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2010-11-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
42925-020 | WI | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
47360 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | UBH | 15-55187 | 01 |
| MN | 378616100 | 05 | |
| MN | BCBS | 405L5PE | 01 |
| MN | HP | 48630 | 01 |
| MN | DEA | BP3790905 | 01 |
| MN | P1 | 1043361 | 01 |
| WI | 1396761276 | 05 | |
| MN | UC | 104348 | 01 |
| Street Address |
1820 APPLETON RD |
| City | MENASHA |
| State | WI |
| Zip Code | 54952-1110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235448093 | Jennie Lee Woreck | Social Worker | 1820 Appleton Rd, Menasha, WI 54952-1110 | 2010-09-28 |
| 1710129176 | Cami Candace Molenaar | Counselor | 1820 Appleton Rd, Menasha, WI 54952-1110 | 2009-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275776239 | Sharon Louise Crowe | Dental Hygienist | 1814 North Appleton Road, Menasha, WI 54952 | 2009-04-07 |
| 1003056110 | Nicole Marie Guyette | Dental Hygienist | 814 N. Appleton Road, Menasha, WI 54952 | 2009-03-02 |
| 1760627624 | Jan Charles Sarnecki | Orthopaedic Surgery | 1814 N. Appleton Road, Menasha, WI 54952 | 2008-12-08 |
| 1588828297 | Lesley R Lathrop | Registered Nurse | 1764 Oakridge Court, Menasha, WI 54952 | 2008-07-11 |
| 1699965137 | Lisa Randerson | Counselor | 1427c Province Terrace, Menasha, WI 54952 | 2007-07-31 |
| 1689748675 | Lisa Lynn Lang Riegel | Dentist | 1155 Wittman Drive, Menasha, WI 54952 | 2006-11-20 |
| 1164596144 | Robert Charles Lang | Dentist | 1155 Wittmann Drive, Menasha, WI 54952 | 2006-11-20 |
| 1366527947 | Karen Patricia Schmidt | Case Manager/Care Coordinator | 1810 Appleton Road, Menasha, WI 54952 | 2006-10-25 |
| 1376647388 | Goodwill Industries of North Central Wi | Counselor | 1800 Appleton Road, Menasha, WI 54952 | 2006-09-11 |
| 1386135614 | Leslie J Steckbauer | Counselor | 1095 Midway Rd, Menasha, WI 54952 | 2018-05-22 |
| Find all providers in zip 54952 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104384387 | Center for Emotional Wellness LLC. | Psychiatry & Neurology | W156n8327 Pilgrim Rd Ste 301, Menomonee Fls, WI 53051-3776 | 2019-03-06 |
| 1295000255 | Ilsa Bick | Psychiatry & Neurology | 1099 Highland Dr, Kohler, WI 53044-1306 | 2012-03-09 |
| 1215268453 | Richard Carl Zimmerman | Psychiatry & Neurology | 1282 E. Green Lake Dr., West Bend, WI 53090-9069 | 2010-01-28 |
| 1184800880 | William M Buzogany | Psychiatry & Neurology | W350 S1401 Waterville Road, Lad Lake Inc, Dousman, WI 53118 | 2008-01-14 |
| 1033300199 | Monika Drummond Roots | Psychiatry & Neurology | 3140 Oxford Rd, Madison, WI 53705-2224 | 2007-08-05 |
| 1598974321 | Marta Cristina Muller | Psychiatry & Neurology | 1941 N Battle Creek Rd, Oconomowoc, WI 53066-9468 | 2007-05-21 |
| 1164517082 | Moitreyee Bandyopadhyay Reddy | Psychiatry & Neurology | 9000 W.wisconsin Avenue, Milwaukee, WI 53201-1997 | 2006-10-04 |
| 1639182868 | Thomas E. Wright | Psychiatry & Neurology | 120 East Main Street, Cambridge, WI 53523-0548 | 2006-08-15 |
| 1447262183 | Neil P Fullan | Psychiatry & Neurology | 2475 University Ave Ste A, Green Bay, WI 54302-5099 | 2006-08-12 |
| 1730134412 | Tracey Cornella-carlson | Psychiatry & Neurology | 721 American Ave Ste 501, Waukesha, WI 53188-5071 | 2006-05-23 |
| 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.