Michael J. Wilczewski, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20184 Issued in NE

Practice address

16909 Q St
Omaha, NE 68135-1521

Phone

(402) 955-7575

Fax

(402) 955-7555

NPI assigned

Sep 20, 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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mwilczewski1515@direct.chsomaha.org

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.

• Children'S Physicians

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1750443503
  NPD (past)
• Children'S West Village Pointe - Diagnostic Services

  • Radiologic Technologist
  • Omaha, NE
  • NPI 1619102613
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1164520367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 W DODGE RD",
            "address_2": "SUITE 280",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143451",
            "telephone_number": "402-955-6877",
            "fax_number": "402-955-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16909 Q ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351521",
            "telephone_number": "402-955-7575",
            "fax_number": "402-955-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCZEWSKI",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "20184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068937239",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "5000",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97572",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507509",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31391",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mercedes Ashtyn Wilcox
• Samantha Wilcox, DPT
• Leann Renee Wilcoxen
• William Edward Wilcoxen Sr.
• Lorie Wilcoxson
• Amy P Wilde, LPN
• Isabel Wilderman
• Wildflower Collective LLC
• Cherena Dawn Wilding
• Marisa Kay Wildrick

• Pediatrics Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.