NPIMap

Individual provider Active NPI

Kwabena Oware Adu-Gyamfi, MD

  • Gastroenterology Physician
  • Green Bay, WI
National Provider Identifier
1154677391
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
63234-20 Issued in WI
Practice address
1860 Shawano Ave
Green Bay, WI 54303-2667
Phone
(920) 496-4700
NPI assigned
Jul 25, 2012
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 63234-20 WI
Internal Medicine Physician 207R00000X 4301100667 MI
Internal Medicine Physician 207R00000X 88509 GA
Gastroenterology Physician 207RG0100X 63234-20 WI Primary

Addresses

Primary practice location

1860 Shawano Ave
Green Bay, WI 54303-2667

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kadugyamfi93972@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150729007482 WI Practitioner - Internal Medicine 2961633375 Reassigns benefits to 6 organizations
I20230612002506 GA Practitioner - Internal Medicine 2961633375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1860 Shawano Ave
Green Bay, WI 54303-2667
Phone (920) 496-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy87
Upper gastrointestinal (GI) endoscopy for acid reflux135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63234-20WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 17, 2017 Accepting new patients
Au Medical Associates Inc CurrentSince May 1, 2023 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 13, 2018 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jun 1, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Aug 17, 2017 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Internal Medicine Current Accepting new patients
Au Medical Associates Inc CurrentSince May 1, 2023 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Aug 20, 2015 Accepting new patients
Beaver Dam Community Hospitals Inc Current Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

1860 Shawano Ave
Green Bay, WI 54303
Phone (920) 272-1010

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

W180N8085 Town Hall Rd
Fl 3
Menomonee Falls, WI 53051

835 S Main St
Oconto Falls, WI 54154
Phone (920) 846-0509

855 S Main St
Oconto Falls, WI 54154
Phone (920) 846-3444

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

Interoperability endpoints

  • Direct secure messaging: kadugyamfi93972@ewd.direct.hshs.org

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1154677391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032667",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADU-GYAMFI",
        "first_name": "KWABENA",
        "middle_name": "OWARE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-25",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "63234-20",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301100667",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "88509",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "63234-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kadugyamfi93972@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1860 Shawano Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543032667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.