Individual provider Active NPI

Patrick A Krzyzewski, DPM

  • Podiatrist
  • Milwaukee, WI
National Provider Identifier
1053496067
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
477025 Issued in WI
Practice address
4100 S Howell Ave
Milwaukee, WI 53207-4410
Phone
(414) 546-3100
Fax
(414) 502-3398
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

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
Podiatrist 213E00000X 477025 WI Primary

Addresses

Primary practice location

4100 S Howell Ave
Milwaukee, WI 53207-4410

Mailing address

4100 S Howell Ave
Milwaukee, WI 53207-4410
Phone (414) 546-3100

Other identifiers 1

IdentifierTypeStateIssuer
30016800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229001056 WI Practitioner - Podiatry 0345356234 Practice locations: Waukesha, WI; South Milwaukee, WI; Milwaukee, WI; Greenfield, WI; Mequon, WI

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Illinois Medical College, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10335 W Oklahoma Ave
Suite 203
Milwaukee, WI 53227-4100
Phone (414) 546-3100

2449 N Downer Ave
Milwaukee, WI 53211-4506
Phone (414) 963-6151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions28
Removal of nail tissue442
Removal or shaving of skin growth175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
477025WIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foot and Ankle Clinic, Inc. Podiatrist PastSince May 17, 2004 Accepting new patients
Visiting Medical Associates Past Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6854/brand/1/csg/1/fhir/r4
  • Direct secure messaging: patrick.krzyzewski.1@12744.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1053496067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 S HOWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532074410",
            "telephone_number": "414-546-3100",
            "fax_number": "414-502-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S HOWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532074410",
            "telephone_number": "414-546-3100",
            "fax_number": "414-502-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRZYZEWSKI",
        "first_name": "PATRICK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "477025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30016800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.