ADVANCED SPINE CENTER OF WISCONSIN, LLC
NPI 1215492061
Clinic/Center - Ambulatory Surgical in Neenah, WI

NPI Status: Active since February 06, 2019

Contact Information

1380 TULLAR RD
NEENAH, WI
ZIP 54956
Phone: (920) 205-0379

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 52D2162605
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 02-25-2027

About ADVANCED SPINE CENTER OF WISCONSIN, LLC

This page provides the complete NPI Profile along with additional information for Advanced Spine Center Of Wisconsin, Llc, a provider established in Neenah, Wisconsin operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1215492061 assigned on February 2019. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated June 2026. The authorized official of this NPI record is Jonathan Bailey (Officer/authorized Official)

NPI
1215492061
Provider Name
ADVANCED SPINE CENTER OF WISCONSIN, LLC
Entity Type
Organization
Location Address
1380 TULLAR RD NEENAH, WI 54956
Location Phone
(920) 205-0379
Mailing Address
1380 TULLAR RD NEENAH, WI 54956
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-06-2019
Last Update Date
06-15-2026
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO
  • Prestige Bronze $0 Medical Deductible - HMO
  • Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
  • Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
  • Prestige Bronze Essential + 3 Free PCP Visits - HMO
  • Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Bronze Plus - HMO
  • Prestige Gold - HMO
  • Prestige Gold 50 + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
  • Prestige Gold Essential + 3Free PCP Visits - HMO
  • Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Silver - HMO
  • Prestige Silver Essential + 3 Free PCP Visits - HMO
  • Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Silver Standard (No Referrals) - HMO
  • UHC Silver Value ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Value+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JONATHAN BAILEY

Authorized Official Title
OFFICER/AUTHORIZED OFFICIAL
Authorized Official Phone
(203) 609-1168

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 26 times for 14 patients

Insertion or replacement of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 13 times for 13 patients

Removal of spine bone for insertion of neurostimulator electrode plate in spine

This procedure involves removing a small part of the spine bone to place a neurostimulator electrode plate. This device can help manage pain signals from the spine to the brain, improving comfort and quality of life. The process is performed by skilled surgeons in a safe environment.

This service was performed 13 times for 13 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
52D2162605
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
February 26, 2025
Certificate Expiration Date
February 25, 2027
Laboratory Director
DANIELLE SCHROEDER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Advanced Spine Center Of Wisconsin, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for ADVANCED SPINE CENTER OF WISCONSIN, LLC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1215492061, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
1
Doubled → 2
Pos 4
5
Unchanged
Pos 5
4
Doubled → 8
Pos 6
9
Unchanged
Pos 7
2
Doubled → 4
Pos 8
0
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 4 → 8 2 → 4 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 2 + 5 + 8 + 9 + 4 + 0 + 1 + 2 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1215492061.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Family Medicine
1380 TULLAR RD
NEENAH, WI 54956
Family Medicine
1380 TULLAR RD
NEENAH, WI 54956
Physician Assistant
1380 TULLAR RD
NEENAH, WI 54956

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215492061, enumerated as an "organization" on February 06, 2019.

The provider is located at 1380 TULLAR RD NEENAH, WI 54956 and the phone number is (920) 205-0379.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource. Please consult your insurance carrier or call the provider to verify.