NPIMap

Individual provider Active NPI

Peter Michael Falk, MD

  • Colon & Rectal Surgery Physician
  • Green Bay, WI
National Provider Identifier
1053424853
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
34387 Issued in WI
Practice address
670 Cormier Road
Green Bay, WI 54304-4824
Phone
(920) 494-9685
Fax
(920) 494-9687
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 34387 WI Primary

Addresses

Primary practice location

670 Cormier Road
Green Bay, WI 54304-4824

Mailing address

670 Cormier Road
Green Bay, WI 54304-4824
Phone (920) 494-9685

Other identifiers 1

IdentifierTypeStateIssuer
31923900MedicaidWI

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
I20040211000768 WI Practitioner - General PracticePractitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 0941106298 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Colorectal Surgery (Proctology)
Education
Oral Roberts University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1860 Shawano Ave
Green Bay, WI 54303-2667
Phone (920) 496-4700

323 S 18TH Ave
Sturgeon Bay, WI 54235-1401
Phone (920) 496-4700

835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy15
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34387WIMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Clare Memorial Hospital, Inc CurrentSince Aug 1, 2016 Accepting new patients
Door County Memorial Hospital CurrentSince Apr 12, 2017 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jan 1, 2019 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Aug 1, 2016 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Mar 1, 2019 Accepting new patients
Door County Memorial Hospital CurrentSince Apr 12, 2017 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Mar 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jan 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

670 Cormier Rd
Green Bay, WI 54304
Phone (920) 494-9685

1860 Shawano Ave
Green Bay, WI 54303
Phone (920) 405-1414

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

835 S Main St
Oconto Falls, WI 54154
Phone (920) 846-0509

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

1843 Michigan St
Sturgeon Bay, WI 54235
Phone (920) 746-0090

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

Organizations & group practices 9

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053424853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 CORMIER ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044824",
            "telephone_number": "920-494-9685",
            "fax_number": "920-494-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 CORMIER ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543044824",
            "telephone_number": "920-494-9685",
            "fax_number": "920-494-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALK",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "WI",
            "license": "34387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31923900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.