Randall Joseph Zblewski, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

24643 Issued in WI

Practice address

12760 W North Ave
Building a
Brookfield, WI 53005-4628

Phone

(262) 439-5500

Fax

(866) 439-5221

NPI assigned

Sep 13, 2006

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1154426617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12760 W NORTH AVE",
            "address_2": "BUILDING A",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054628",
            "telephone_number": "262-439-5500",
            "fax_number": "866-439-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12760 W NORTH AVE",
            "address_2": "BUILDING A",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054628",
            "telephone_number": "262-439-5500",
            "fax_number": "866-439-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZBLEWSKI",
        "first_name": "RANDALL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "24643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rzblewski9460@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12760 W North Ave",
            "address_2": "Building A",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530054628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "12760 W North Ave",
            "address_2": "Building A",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530054628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melissa Zahn
• Stacey K Zahn, OCCUPATIONAL THERAP
• Dawn M Zahrt, PHD
• Nicholas James Zajdel, MD
• Kelly A Zalog, P.A.
• Deborah Zdarstek, CRNA
• Melissa Zebrasky
• James Herbert Zellmer, M.D.
• Natalie J. Zellmer
• Katie Zenner, DPT

• Psychiatry Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.