Individual provider Active NPI

Stefan G Doerge, M.D.

  • Diagnostic Radiology Physician
  • Milwaukee, WI
National Provider Identifier
1295034445
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
59478-20 Issued in WI
Practice address
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone
(414) 649-3323
NPI assigned
Mar 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 59478-20 WI Primary

Addresses

Primary practice location

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330

Mailing address

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6000

Other identifiers 1

IdentifierTypeStateIssuer
100031141MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sdoerge22942@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20170616001122 WI Practitioner - Diagnostic Radiology 3072803261 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Eastern Virginia Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1005 Spring City Dr
Waukesha, WI 53186-5934
Phone (262) 371-4040

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

1032 E Sumner St
Hartford, WI 53027-1608
Phone (262) 673-2300

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

120 Chapman Farms Blvd
Mukwonago, WI 53149-9337
Phone (262) 363-6160

12500 Aurora Dr
Pleasant Prairie, WI 53158-1227
Phone (262) 857-5000

13250 Washington Ave
Mount Pleasant, WI 53177-1516
Phone (262) 884-4000

1346 E Green Bay St
Shawano, WI 54166-2210
Phone (715) 526-6244

146 E Geneva SQ
Lake Geneva, WI 53147-9694
Phone (262) 249-5000

2000 E Layton Ave
Suite 130
St Francis, WI 53235-6067
Phone (414) 747-8856

210 Wisconsin American Dr
Fond Du Lac, WI 54937-2999
Phone (920) 907-4800

248 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-8000

252 McHenry St
Burlington, WI 53105-1828
Phone (262) 767-7000

2600 Kiley Way
Plymouth, WI 53073-5020
Phone (920) 449-7000

2621 S Green Bay Rd
Racine, WI 53406-4948
Phone (262) 504-6100

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 646-5410

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 828-2530

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

4061 Old Peshtigo Rd
Marinette, WI 54143-3887
Phone (715) 732-8000

5000 Memorial Dr
Two Rivers, WI 54241-3900
Phone (920) 794-5000

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-9000

6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Phone (414) 421-8400

709 Spring Valley Rd
Burlington, WI 53105-7614
Phone (262) 767-6020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59478-20WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 10, 2017 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jul 10, 2017 Accepting new patients
Aurora Medical Group, Inc. Diagnostic Radiology CurrentSince Jul 10, 2017 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jul 10, 2017 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Jul 10, 2017 Accepting new patients

Locations

112 N US Highway 141
Crivitz, WI 54114
Phone (715) 735-6621

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

4061 Old Peshtigo Rd
Marinette, WI 54143
Phone (715) 732-8000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

5818 W Capitol Dr
Milwaukee, WI 53216
Phone (414) 447-8071

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
Ste 130
St Francis, WI 53235
Phone (414) 747-8856

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

4025 N 92nd St
Wauwatosa, WI 53222
Phone (414) 358-5431

Interoperability endpoints

  • Direct secure messaging: sdoerge22942@direct.myadvocateaurora.org

Organizations & group practices 5

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1295034445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERGE",
        "first_name": "STEFAN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-26",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "59478-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100031141",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdoerge22942@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.