Kenneth Urlakis Jr., M.D., PHD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37072-20 Issued in WI

Practice address

631 Violet CT
Colgate, WI 53017-9319

Phone

(262) 388-6217

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Froedtert & the Medical College of Wisconsin Community Physicians Inc.

  • Non-Pharmacy Dispensing Site
  • Wauwatosa, WI
  • NPI 1649626540
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1265407316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 VIOLET CT",
            "city": "COLGATE",
            "state": "WI",
            "postal_code": "530179319",
            "telephone_number": "262-388-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 VIOLET CT",
            "city": "COLGATE",
            "state": "WI",
            "postal_code": "530179319",
            "telephone_number": "262-388-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URLAKIS",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37072",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "37072-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32309000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Pierce
• Lauren Pollpeter, PT
• Jennifer Lea Runde
• Ethan Sawyer
• Kathryn Soley, RN
• Mary Anne Urlakis, M.A., PH.D.
• Erica Lynn Van Serke, MS CCC-SLP
• Waw Mind and Body
• Sarah E. Wawrzyniak, APNP

• Family Medicine Physician in Colgate, WI
• Providers in Colgate, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.