Andrew Thomas Konicek, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

64321-21 Issued in WI

Practice address

3801 Spring Street
Racine, WI 53403-1010

Phone

(262) 687-4011

NPI assigned

Jun 22, 2010

Sex

Male

Sole proprietor

No

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

Emergency Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
• Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
• Ascension Wisconsin Hosp Menomonee Falls Campus Hospital, Menomonee Falls, WI, CCN 520214

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Emergency Medicine Specialists, S.C.

  • Emergency Medicine Physician
  • Milwaukee, WI
  • NPI 1568413524
  Medicare reassignment Care Compare group
• Ascension Calumet Hospital, Inc

  • Critical Access Hospital
  • Chilton, WI
  • NPI 1376541748
  Medicare reassignment NPD

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

• Ascension All Saints Hospital, Inc

  • General Acute Care Hospital
  • Racine, WI
  • NPI 1639123284
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1427007384
  Care Compare affiliation
• Ascension SE Wisconsin Hospital, Inc

  • Rehabilitation Hospital Unit
  • Brookfield, WI
  • NPI 1861417362
  Care Compare affiliation
• Ascension Wisconsin Emerus Menomonee Falls, LLC

  • General Acute Care Hospital
  • Menomonee Falls, WI
  • NPI 1063018927
  Care Compare affiliation
• Ascension Wisconsin Emerus Menomonee Falls, LLC

  • General Acute Care Hospital
  • Waukesha, WI
  • NPI 1225635592
  Care Compare affiliation
• Ascension Wisconsin Emerus Menomonee Falls, LLC

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1255938510
  Care Compare affiliation

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1073824207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9874 W PRAIRIE GRASS WAY",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531327201",
            "telephone_number": "847-404-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 SPRING STREET",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031010",
            "telephone_number": "262-687-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONICEK",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-22",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "64321-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Koderca
• Carl Tyrone Koeling, M.S., LPC
• Jennifer Koenig, PHARMD
• Rebecca Koeppen, RD, CD
• Mary Koke
• Dennis J Kontra, MD
• Nakia Daisy Konwent, PTA
• Pamela Jean Koonz, LCSW CSAC
• Eric Christian Koski Sr., PHARMD
• Christina B Kosterman, RN

• Emergency Medicine Physician in Racine, WI
• Providers in Racine, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.