FOX VALLEY SURGICAL ASSOCIATES LTD
NPI 1750574711
Non-Pharmacy Dispensing Site in Appleton, WI

NPI Status: Active since August 23, 2007

Contact Information

2105 E ENTERPRISE AVE
APPLETON, WI
ZIP 54913
Phone: (952) 653-2528

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Non-Pharmacy Dispensing Site
Accepts Insurance
CLIA Number: 52D2295719
CLIA Cert. Type: Ambulatory Surgery Center
CLIA Exp. Date: 12-14-2025

About FOX VALLEY SURGICAL ASSOCIATES LTD

This page provides the complete NPI Profile along with additional information for Fox Valley Surgical Associates Ltd, a provider established in Appleton, Wisconsin operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1750574711 assigned on August 2007. The practitioner's primary taxonomy code is 332900000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Curt Kubiak (Executive Director)

NPI: 1750574711
Provider Name: FOX VALLEY SURGICAL ASSOCIATES LTD
Entity Type: Organization
Location Address: 2105 E ENTERPRISE AVE APPLETON, WI 54913
Location Phone: (952) 653-2528
Mailing Address: 6501 CITY WEST PKWY EDEN PRAIRIE, MN 55344
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 08-23-2007
Last Update Date: 06-18-2008
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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: Non-Pharmacy Dispensing Site
Taxonomy Code: 332900000X
Type: Suppliers
Taxonomy Description: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

Insurance Plans Accepted

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

Blue Cross and Blue Shield of Illinois

Blue Choice Preferred Bronze PPO? 201 - PPO
Blue Choice Preferred Bronze PPO? 701 - PPO
Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
Blue Choice Preferred Gold PPO? 204 - PPO
Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
Blue Choice Preferred Security PPO? 200 - PPO
Blue Choice Preferred Silver PPO? 203 - PPO
Blue Choice Preferred Silver PPO? 801 - PPO
Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO

Blue Cross and Blue Shield of Oklahoma

Blue Advantage Bronze PPO? 202 - PPO
Blue Advantage Bronze PPO? 203 - PPO
Blue Advantage Bronze PPO? Standard - PPO
Blue Advantage Gold PPO? 309 - PPO
Blue Advantage Gold PPO? 604 - PPO
Blue Advantage Gold PPO? Standard - PPO
Blue Advantage Silver PPO? 204 - PPO
Blue Advantage Silver PPO? 501 - PPO
Blue Advantage Silver PPO? Standard - PPO
Blue Preferred Bronze PPO? Standard - PPO

Blue Cross and Blue Shield of Texas

Blue Advantage Bronze HMO? 204 - HMO
Blue Advantage Bronze HMO? 301 - HMO
Blue Advantage Bronze HMO? Standard - HMO
Blue Advantage Gold HMO? 206 - HMO
Blue Advantage Gold HMO? 603 - HMO
Blue Advantage Gold HMO? Standard - HMO
Blue Advantage Plus Bronze? 303 - POS
Blue Advantage Plus Bronze? 305 - POS
Blue Advantage Plus Bronze? Standard - POS
Blue Advantage Plus Gold? 203 - POS

Medica

Select by Medica Bronze $0 Copay PCP Visits - EPO
Select by Medica Bronze Share - EPO
Select by Medica Expanded Bronze Standard - EPO
Select by Medica Gold $0 Copay PCP Visits - EPO
Select by Medica Gold Share - EPO
Select by Medica Gold Standard - EPO
Select by Medica Silver $0 Copay PCP Visits - EPO
Select by Medica Silver Share - EPO
Select by Medica Silver Standard - EPO

Moda Health Plan, Inc.

Moda Health Affinity Bronze 7750 - EPO
Moda Health Affinity Bronze 9000 - EPO
Moda Health Affinity Bronze HDHP 7500 - EPO
Moda Health Affinity Gold 1000 - EPO
Moda Health Affinity Gold 1500 - EPO
Moda Health Affinity Gold 250 - EPO
Moda Health Affinity Silver 3000 - EPO
Moda Health Affinity Silver 3400 - EPO
Moda Health Affinity Silver 4500 - EPO
Moda Health Affinity Silver 6000 - EPO

Primewell Health Services of Mississippi

Essential Bronze 6500 - POS
Essential Gold 1500 - POS
Freedom Silver 4000 - POS
Savings Bronze 7700 - POS
Standard Bronze 7500 - POS
Standard Gold 1500 - POS
Standard Silver 5000 - POS

Security Health Plan

Enrich $1,500 - 25% - HMO
Enrich $3,500 - 30% - HMO
Enrich $4,100 HDHP - HMO
Enrich $5,000 - 40% - HMO
Enrich $6,200 HDHP - HMO
Enrich $7,500 - HMO
Enrich $9,200 - HMO
Enrich Protection - HMO
Premier $1,500 - 25% - HMO
Premier $3,500 - 30% - 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: CURT KUBIAK
Authorized Official Title: EXECUTIVE DIRECTOR
Authorized Official Phone: (952) 653-2528

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: 52D2295719
Facility Type: Ambulatory Surgery Center
Certificate Effective Date: December 15, 2023
Certificate Expiration Date: December 14, 2025
Laboratory Director: DR. RAYMON SOHN
Certificate Type: Certificate of Waiver
Certificate Type Description: This CLIA certificate is issued to Fox Valley Surgical Associates Ltd 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.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	5	0	5	7	4	7	1	1
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	10	0	10	7	8	7	2
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 0 + 7 + 8 + 7 + 2 + 24 = 59
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 59 = 1									1

The NPI number 1750574711 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 20 providers are registered at the same or nearby location.

MRS. MARGARET MARY HAU OT

Occupational Therapist

2105 E ENTERPRISE AVE
APPLETON, WI
ZIP 54913

About FOX VALLEY SURGICAL ASSOCIATES LTD

Location Map

Specialty - Primary Taxonomy

Non-Pharmacy Dispensing Site

Insurance Plans Accepted

Authorized Official

CURT KUBIAK

CLIA Information

Reviews for FOX VALLEY SURGICAL ASSOCIATES LTD

NPI Validation Check Digit Calculation

Other Providers at the Same Location

Frequently Asked Questions