Simonida Kokanovic, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

50383020 Issued in WI

Practice address

21425 Spring St
Union Grove, WI 53182-9707

Phone

(262) 878-2411

Fax

(262) 878-2922

NPI assigned

Jul 1, 2011

Last updated

Jun 11, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of WisconsinGroup PAC ID 9234181751, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• State of Wisconsin

  • General Acute Care Hospital
  • Madison, WI
  • NPI 1437253648
  Medicare reassignment Care Compare group NPD

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

• Ascension All Saints Hospital, Inc

  dba Ascension All Saints Hospital

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284
  Care Compare affiliation
• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1063709749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21425 SPRING ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531829707",
            "telephone_number": "262-878-2411",
            "fax_number": "262-878-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21425 SPRING ST",
            "city": "UNION GROVE",
            "state": "WI",
            "postal_code": "531829707",
            "telephone_number": "262-878-2411",
            "fax_number": "262-878-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOKANOVIC",
        "first_name": "SIMONIDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "50383020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hospice Advantage, LLC
• Kevin M Huckstorf, DPT
• Heather S. Huebner, DPT
• Karrylyn K Kais
• Amie Koehnlein, LPC
• Sarah Koldeway, PHARMD
• Elizabeth P Kravig, DDS
• Lane Thomas Laclair, DPT, CSCS, NSCA-CPT
• Mary Lakomy, PTA
• Kristin Marie Lenz Galbreath, DMD

• Family Medicine Physician in Union Grove, WI
• Providers in Union Grove, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.