Active NPI
Patrick N Koenig, M.D.
- Anesthesiology Physician
- Pewaukee, WI
National Provider Identifier
1124001607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 37447-020
- Practice address
- N15W28300 Golf Rd
Pewaukee, WI 53072-4800 - Phone
- (262) 544-5311
- Fax
- (262) 303-5006
- NPI assigned
- Nov 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 37447-020 | WI | Primary |
Addresses
Primary practice location
N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Mailing address
N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124001607 | Medicaid | WI | |
| 050073336 | Other | RAIL ROAD MEDICARE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Wright State University Boonshoft School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37447-020 | WI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Associates of Wisconsin SC | Current | Accepting new patients | |
| Orthopaedic Associates of Wisconsin, SC | Current | Accepting new patients | |
| Anesthesiology Associates of Wisconsin, S.C. | Anesthesiology | Past | Accepting new patients |
Locations
N15W28300 Golf Rd
Pewaukee, WI 53072
725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011
Interoperability endpoints
- pkoenig4175@direct.phci.org
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.
-
- Orthopaedic Surgery Physician
- Pewaukee, WI
- NPI 1689656951
-
- Orthopaedic Surgery Physician
- Mukwonago, WI
- NPI 1720433790
-
- Anesthesiology Physician
- Milwaukee, WI
- NPI 1578518353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573430400000",
"number": "1124001607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N15W28300 GOLF RD",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530724800",
"telephone_number": "262-303-5000",
"fax_number": "262-303-5006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N15W28300 GOLF RD",
"city": "PEWAUKEE",
"state": "WI",
"postal_code": "530724800",
"telephone_number": "262-544-5311",
"fax_number": "262-303-5006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOENIG",
"first_name": "PATRICK",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-29",
"last_updated": "2019-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WI",
"license": "37447-020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124001607",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "050073336",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pewaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.