Individual provider Active NPI

Gerard W Dynkowski, M.D.

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1255383790
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
36545-020 Issued in WI
Practice address
111 E Wisconsin Ave
Suite 2000
Milwaukee, WI 53202-4815
Phone
(414) 290-6720
Fax
(414) 290-6755
NPI assigned
May 16, 2006
Last updated
Jan 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 36545-020 WI Primary

Addresses

Primary practice location

111 E Wisconsin Ave
Suite 2000
Milwaukee, WI 53202-4815

Mailing address

111 E Wisconsin Ave
Suite 2000
Milwaukee, WI 53202-4815
Phone (414) 290-6720

Other identifiers 4

IdentifierTypeStateIssuer
110136769OtherWIMEDICARE RAILROAD
32125600MedicaidWI
P00024347OtherWIMEDICARE RAILROAD
930106599OtherWIMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090521000575 WI Practitioner - Emergency Medicine 7012066012 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36545-020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince Mar 6, 2024 Accepting new patients
American Current Care PA Current Accepting new patients
American Current Care P.a. Current Accepting new patients
American Current Care PA CurrentSince Mar 6, 2024 Accepting new patients
Ihc Beaver Dam Emergency Physicians, LLC Emergency Medicine CurrentSince Nov 25, 2009 Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

2455 N 124th St
Brookfield, WI 53005
Phone (262) 782-9326

5040 W Ashland Way
Franklin, WI 53132
Phone (414) 858-0100

2920 Ramada Way
Green Bay, WI 54304
Phone (920) 305-0360

6302 75th St
Kenosha, WI 53142
Phone (262) 771-0770

358 Junction Rd
Madison, WI 53717
Phone (608) 829-1888

4260 E Towne Blvd
Madison, WI 53704
Phone (608) 244-1213

111 E Wisconsin Ave
Ste 2000
Milwaukee, WI 53202
Phone (414) 290-6700

215 N 35th St
Milwaukee, WI 53208
Phone (414) 931-7600

5500 W Brown Deer Rd
Ste 400
Milwaukee, WI 53223
Phone (414) 355-4300

S30W24896 W Sunset Dr
Waukesha, WI 53189
Phone (262) 226-2243

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1255383790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "address_2": "SUITE 2000",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "address_2": "SUITE 2000",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYNKOWSKI",
        "first_name": "GERARD",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "36545-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110136769",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32125600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00024347",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "930106599",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.