APPLETON PLASTIC SURGERY CENTER, SC — NPI 1235246869 (Licensed & Credentialed Allopathic & Osteopathic Physicians

CMS-1500 Box 24J / 33a • NPI

1235246869

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

208200000X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery

Box 32 Service Location & ZIP+4

5605 WATERFORD LN, APPLETON, WI, 54913-8438

✓ 9-Digit EDI 837 ZIP+4 (54913-8438)

Practice Phone & Referral Fax

(920) 738-7200

Fax: (920) 273-2500

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1235246869 (APPLETON PLASTIC SURGERY CENTER, SC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1235246869` (NPI-2 Organization / Facility)
Provider / Legal Name	APPLETON PLASTIC SURGERY CENTER, SC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery NUCC Code: `208200000X` (Plastic Surgery)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	5605 WATERFORD LN, APPLETON, WI, 54913-8438
Practice Telephone / Fax	Tel: (920) 738-7200 \| Fax: (920) 273-2500
Administrative Mailing Address	5605 WATERFORD LN, APPLETON, WI, 54913-8438
Enumeration & Last Sync	Enumerated: 2006-08-23 \| CMS Record Updated: 2019-04-04
Authorized Official	MEREDITH KIESNOWSKI (Administrator)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5605 WATERFORD LN, APPLETON, WI, 54913-8438

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Plain-English Taxonomy & CMS Crosswalk (208200000X)

What Does Taxonomy Code 208200000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208200000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 24 (Physician/Plastic and Reconstructive Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Plastic Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (APPLETON PLASTIC SURGERY CENTER, SC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`208200000X` — Plastic Surgery Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Plastic Surgery	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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APPLETON PLASTIC SURGERY CENTER, SC (NPI #1235246869)