Andrew Kordus, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

69731 Issued in WI

Practice address

4030 Treffert Dr
Winnebago, WI 54901

Phone

(920) 235-4910

NPI assigned

Apr 8, 2017

Last updated

Oct 29, 2021By the provider in NPPES

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

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

Specialty

Psychiatry

Education

Nova Southeastern College of Osteo Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Waukesha CountyGroup PAC ID 3971405481, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Waukesha County

  • Case Management Agency
  • Waukesha, WI
  • NPI 1740403146
  Medicare reassignment Care Compare group NPD
• County of Outagamie

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1629138995
  Medicare reassignment NPD
• Waukesha County

  • Psychiatric Hospital
  • Waukesha, WI
  • NPI 1407988892
  NPD
• Waukesha County

  • Mental Illness Community Based Residential Treatment Facility
  • Waukesha, WI
  • NPI 1477314854
  NPD
• Winnebago Mental Health Institute

  • Psychiatric Hospital
  • Winnebago, WI
  • NPI 1164516506
  NPD (past)

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

{
    "created_epoch": "1491609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1285167031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SOUTH DRIVE",
            "city": "WINNEBAGO",
            "state": "WI",
            "postal_code": "549850009",
            "telephone_number": "920-235-4910",
            "fax_number": "920-431-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 TREFFERT DR",
            "city": "WINNEBAGO",
            "state": "WI",
            "postal_code": "54901",
            "telephone_number": "920-235-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDUS",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-08",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "69731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle M Hermes, APNP
• Kimberly Sue Hoenecke, D.O.
• Deanna Lynn Kapitzke, APNP, PMHNP-BC
• Randy M Kerswill, M.D.
• Stephanie Ann Kerswill, MD
• Margaret Lehnert, M..D.
• Katelyn Lois Lenz, PMHNP-BC
• Aquila Lesko, M.D.
• Anthony M Lichtfuss, LCSW
• Alla Y Likhterev, M.D.

• Psychiatry Physician in Winnebago, WI
• Providers in Winnebago, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.
• 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.