Active NPI
Andrew C Pahl, M.D.
- Internal Medicine Physician
- Kaukauna, WI
National Provider Identifier
1194807925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 38085
- Practice address
- 2700 Crooks Ave
Kaukauna, WI 54130-3900 - Phone
- (920) 830-5900
- Fax
- (920) 738-5787
- NPI assigned
- Oct 20, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 38085 | WI | Primary |
Addresses
Primary practice location
2700 Crooks Ave
Kaukauna, WI 54130-3900
Mailing address
2700 Crooks Ave
Kaukauna, WI 54130-3900
Phone (920) 830-5900
Other practice location 1
100 County Road B
Shawano, WI 54166-7072
Phone (715) 524-2161
Other practice location 2
100 County Road B
Shawano, WI 54166-7072
Phone (715) 524-2161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3055 | Other | INTERNAL ID-MOTOR VEHICLE ID |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | apahl393@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38085 | WI | MD | Internal Medicine Physician |
Interoperability endpoints
- apahl393@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1194807925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 CROOKS AVE",
"city": "KAUKAUNA",
"state": "WI",
"postal_code": "541303900",
"telephone_number": "920-830-5900",
"fax_number": "920-738-5787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 CROOKS AVE",
"city": "KAUKAUNA",
"state": "WI",
"postal_code": "541303900",
"telephone_number": "920-830-5900",
"fax_number": "920-738-5787"
}
],
"practiceLocations": [
{
"address_1": "100 County Road B",
"address_purpose": "LOCATION",
"city": "Shawano",
"state": "WI",
"postal_code": "541667072",
"country_code": "US",
"telephone_number": "715-524-2161",
"fax_number": "715-524-8164",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 County Road B",
"address_purpose": "LOCATION",
"city": "Shawano",
"state": "WI",
"postal_code": "541667072",
"country_code": "US",
"telephone_number": "715-524-2161",
"fax_number": "715-524-8164",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAHL",
"first_name": "ANDREW",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "38085",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL ID-MOTOR VEHICLE ID",
"identifier": "3055",
"state": null
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "100 County Road B",
"city": "Shawano",
"state": "WI",
"country_code": "US",
"postal_code": "541667072",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "apahl393@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "100 County Road B",
"city": "Shawano",
"state": "WI",
"country_code": "US",
"postal_code": "541667072",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.