Individual provider Active NPI

Ahmet U. Demircioglu, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • St Francis, WI
National Provider Identifier
1114005642
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
46202 Issued in WI
Practice address
2000 E Layton Ave Ste 170
St Francis, WI 53235-6055
Phone
(414) 744-6589
Fax
(414) 747-8848
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 46202 WI Primary
Internal Medicine Physician 207R00000X 46202 WI

Addresses

Primary practice location

2000 E Layton Ave Ste 170
St Francis, WI 53235-6055

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

3305 S 20th St Ste 100
Milwaukee, WI 53215-4940
Phone (414) 645-1808

Other identifiers 1

IdentifierTypeStateIssuer
34580100MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address ademircioglu23648@direct.myadvocateaurora.org Direct

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040924000319 WI Practitioner - Internal Medicine 6406824655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46202WIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic, LLC CurrentSince Sep 1, 2004 Accepting new patients

Locations

3305 S 20th St
Ste 100
Milwaukee, WI 53215
Phone (414) 645-1808

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

100 15th Ave
Ste 180
South Milwaukee, WI 53172
Phone (414) 768-5430

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

2000 E Layton Ave
Ste 170
St Francis, WI 53235
Phone (414) 294-4570

Organizations & group practices 1

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 5

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1114005642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E LAYTON AVE STE 170",
            "city": "ST FRANCIS",
            "state": "WI",
            "postal_code": "532356055",
            "telephone_number": "414-744-6589",
            "fax_number": "414-747-8848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3305 S 20th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154940",
            "country_code": "US",
            "telephone_number": "414-645-1808",
            "fax_number": "414-645-1170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMIRCIOGLU",
        "first_name": "AHMET",
        "middle_name": "U.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WI",
            "license": "46202",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "46202",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34580100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2000 E Layton Ave Ste 170",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ademircioglu23648@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2000 E Layton Ave Ste 170",
            "city": "St Francis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532356055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Francis, WI

Sources for this page

Verify at the official NPI Registry.