NPIMap

Individual provider Active NPI

Heather M Stefaniak, MD

  • Urology Physician
  • Green Bay, WI
National Provider Identifier
1013139641
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
51127 Issued in WI
Practice address
2845 Greenbrier Rd Ste 240
Green Bay, WI 54311-6519
Phone
(920) 288-8280
Fax
(920) 288-8285
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 51127 WI Primary

Addresses

Primary practice location

2845 Greenbrier Rd Ste 240
Green Bay, WI 54311-6519

Mailing address

2845 Greenbrier Rd Ste 240
PO Box 8900
Green Bay, WI 54311-6519
Phone (920) 288-8280

Other identifiers 1

IdentifierTypeStateIssuer
35105300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080811000422 WI Practitioner - Urology 9436223377 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical College of Wisconsin, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Aurora LLCGroup PAC ID 0244130557, 197 clinicians

Practice addresses (Care Compare)

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8000

Hospital & facility affiliations

  • Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193
  • Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358
  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113
  • Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51127WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2014 Accepting new patients
Baycare Clinic LLP CurrentSince Sep 1, 2008 Accepting new patients
Baycare Clinic LLP CurrentSince Sep 1, 2008 Accepting new patients
Baycare Aurora, LLC CurrentSince Jul 24, 2017 Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Ste 240
Green Bay, WI 54311
Phone (920) 288-8280

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

Networks

  • IL PPO Downstate
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • IL HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: hstefaniak60578@direct.myadvocateaurora.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1013139641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD STE 240",
            "address_2": "PO BOX 8900",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8280",
            "fax_number": "920-288-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2845 GREENBRIER RD STE 240",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116519",
            "telephone_number": "920-288-8280",
            "fax_number": "920-288-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFANIAK",
        "first_name": "HEATHER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "51127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35105300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.