Organization Active NPI

Paul B Doenier MD, SC

  • Family Medicine Physician
  • Waukesha, WI
National Provider Identifier
1235672239
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
49232 Issued in WI
Legal business name
PAUL B DOENIER MD, SC
Practice address
1111 Delafield St Ste 300
Waukesha, WI 53188-3407
Phone
(262) 446-0955
Fax
(262) 446-0055
NPI assigned
Nov 22, 2016
Last updated
Mar 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Paul B Doenier, M.D.NPI 1720030489
Title
President
Phone
(262) 446-0955

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 49232 WI Primary

Addresses

Primary practice location

1111 Delafield St Ste 300
Waukesha, WI 53188-3407

Mailing address

1111 Delafield St Ste 300
Waukesha, WI 53188-3407
Phone (262) 446-0955

Other identifiers 2

IdentifierTypeStateIssuer
K400354306OtherWIINDIVIDUAL PTAN
K100354297OtherWIGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170110001350 WI Part B Supplier - Clinic/Group Practice 8426339276 Receives reassigned benefits from 1 practitioner
Practice locations: Waukesha, WI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2275372Paul B Doenier MD, SC1111 Delafield St, Ste 300, Waukesha, WI 53188Certificate of waiverJan 19, 2027

National Provider Directory

National Provider Directory

Locations

1111 Delafield St
Ste 300
Waukesha, WI 53188
Phone (262) 446-0955

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1235672239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST STE 300",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883407",
            "telephone_number": "262-446-0955",
            "fax_number": "262-446-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST STE 300",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883407",
            "telephone_number": "262-446-0955",
            "fax_number": "262-446-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL B DOENIER MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2023-03-24",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "DOENIER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-446-0955",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "49232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "K400354306",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "K100354297",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.