Bryan J Roberts (NPI# 1275929010, PAC ID# 8820360498) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1275929010 |
| PAC ID by PECOS | 8820360498 |
| Professional Enrollment ID | I20180828004186 |
| Full Name | Bryan J Roberts |
| Organization Legal Name | THEDACARE INCORPORATED |
| Address |
W5282 Amy Ave Appleton WI 54915-7233 |
| Phone Number | 9203581900 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF WISCONSIN |
| Graduation Year | 2015 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1759294887 |
| Number of Group Practice Members | 478 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520045 | THEDA CLARK MEDICAL CENTER |
| 520160 | THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC |
| Address | Phone | Organization |
|---|---|---|
| W5282 Amy Ave, Appleton, WI 54915-7233 | 9203581900 | THEDACARE INCORPORATED |
| 2005 Midway Rd, Menasha, WI 54952-7002 | 9208328500 | THEDACARE INCORPORATED |
| Organization Legal Name | THEDACARE INCORPORATED |
| Physicians | 485 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew J Kubisch | Physician Assistant | Thedacare Incorporated | 1405 Mill St, New London, WI 54961-2155 |
| Anna L King | Physician Assistant | Thedacare Incorporated | 1818 N Meade St Room, N255, Appleton, WI 54911-3454 |
| Roger B Collins | Orthopedic Surgery | Thedacare Incorporated | 130 2nd St, Neenah, WI 54956-2883 |
| Jennifer E Szmanda | Pediatric Medicine | Thedacare Incorporated | 640 Deerwood Ave, Neenah, WI 54956-7110 |
| Elizabeth A Barthel | Nurse Practitioner | Thedacare Incorporated | 2500 E Capitol Dr, Fl 2, Appleton, WI 54911-8735 |
| Carmen L Miller | Nurse Practitioner | Thedacare Incorporated | 710 Riverside Dr, Waupaca, WI 54981-1941 |
| Kathleen M Erdahl | Nurse Practitioner | Thedacare Incorporated | 1000 W Northland Ave, Appleton, WI 54914-1419 |
| Jennifer L Kohnke | Nurse Practitioner | Thedacare Incorporated | 670 Country Rd A, Green Lake, WI 54941-8608 |
| Taylor B Doberstein | Rheumatology | Thedacare Incorporated | 200 Theda Clark Medical Plaza, Suite 350, Neenah, WI 54956-2790 |
| Rachel A Savage | Nurse Practitioner | Thedacare Incorporated | 400 S Maple St, Black Creek, WI 54106-9787 |
| Street Address |
W5282 AMY AVE |
| City | APPLETON |
| State | WI |
| Zip | 54915-7233 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott M Schuldes | Nurse Practitioner | Thedacare Incorporated | W5282 Amy Ave, Appleton, WI 54915-7233 |
| Adam R Olson | Family Medicine | Thedacare Incorporated | W5282 Amy Ave, Appleton, WI 54915-7233 |
| Douglas P Moard | Family Medicine | Thedacare Incorporated | W5282 Amy Ave, Appleton, WI 54915-7233 |
| Joshua R Block | Family Medicine | Thedacare Incorporated | W5282 Amy Ave, Appleton, WI 54915-7233 |
| Sharon L Rink | Pediatric Medicine | Thedacare Incorporated | W5282 Amy Ave, Appleton, WI 54915-7233 |
| Jennifer L Mattioli | Nurse Practitioner | Thedacare Incorporated | W5282 Amy Ave, Appleton, WI 54915-7233 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica Friday | Nurse Practitioner | Apple Medical Clinic Sc | 2000 S Memorial Dr, Suite 201, Appleton, WI 54915-1237 |
| Michael L Johnson | Chiropractic | Apple Medical Clinic Sc | 2000 S Memorial Dr, Suite 201, Appleton, WI 54915-1237 |
| Carl M Williams | Critical Care (intensivists) | Ascension Medical Group-fox Valley Wisconsin, Inc | 1506 S Oneida St, Appleton, WI 54915-1305 |
| Richard L Erdman | Emergency Medicine | Ihc-wound Care Services LLC | 1506 Oneida St S, Appleton, WI 54915-1305 |
| Alicia M Schumacher | Nurse Practitioner | Ascension Ne Wisconsin, Inc | 1506 S Oneida St, Appleton, WI 54915-1305 |
| Efe M Akpoigbe | Hospitalist | Ascension Medical Group-fox Valley Wisconsin, Inc | 1506 S Oneida St, Appleton, WI 54915-1305 |
| Debra L Franciosi | Nurse Practitioner | Ascension Medical Group-fox Valley Wisconsin, Inc | 1506 S Oneida St, Appleton, WI 54915-1305 |
| Bradley C Heraly | Internal Medicine | Ascension Ne Wisconsin, Inc | 1506 S Oneida St, Appleton, WI 54915-1305 |
| Mark W Faustich | Obstetrics/gynecology | Ascension Medical Group-fox Valley Wisconsin, Inc | 1506 S Oneida St, Appleton, WI 54915-1305 |
| Kathleen A Clarke | Psychologist, Clinical | Ascension Ne Wisconsin, Inc | 1506 S Oneida St, Appleton, WI 54915-1305 |
| Find all physicians in zip 54915 | |||
| City | APPLETON |
| Zip Code | 54915 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | APPLETON + FAMILY MEDICINE |
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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.