Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Simon Edwin Roselaar, MD

Individual provider Internal Medicine Physician · NPI 1689626632

Mr. Simon Edwin Roselaar, MD is a Cardiovascular Disease (Cardiology) in Appleton, Wisconsin. Qualified in 1994, 32 years ago. Practices with Ascension Medical Group-Fox Valley Wisconsin, Inc, a 260-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
32
Licensed in
WI
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5045 W Grande Market Dr
Appleton, WI 54913-8517
Phone: (920) 886-9380
Fax: (920) 886-9381
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence 40974-020 (WI)
Internal Medicine Physician Taxonomy 207R00000X · Licence 40974-020 (WI)
Nuclear Cardiology Physician Taxonomy 207UN0901X · Licence 40974-020 (WI)

Record details

NPI number1689626632
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 17, 2006
Last updated in NPPESMarch 26, 2020
Certification dateMarch 26, 2020
Mailing addressBin 88040, Milwaukee, WI 53288-0040

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolOTHER
Graduated 1994 (32 years in practice)
Group practice Ascension Medical Group-Fox Valley Wisconsin, Inc — 260 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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