Dennis J Kontra, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

15656 020 Issued in WI

Practice address

5802 Washington Ave
Ste 102
Racine, WI 53406-4088

Phone

(262) 886-9100

Fax

(262) 886-9130

NPI assigned

Oct 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Surgicenter of Racine LTD

  • Ambulatory Surgical Clinic/Center
  • Racine, WI
  • NPI 1518957851
  NPD (past) Authorized official

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1306835319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 WASHINGTON AVE",
            "address_2": "STE 102",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064088",
            "telephone_number": "262-886-9100",
            "fax_number": "262-886-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 WASHINGTON AVE",
            "address_2": "STE 102",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534064088",
            "telephone_number": "262-886-9100",
            "fax_number": "262-886-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONTRA",
        "first_name": "DENNIS",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "15656 020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31175100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl Tyrone Koeling, M.S., LPC
• Jennifer Koenig, PHARMD
• Rebecca Koeppen, RD, CD
• Mary Koke
• Andrew Thomas Konicek, D.O.
• Nakia Daisy Konwent, PTA
• Pamela Jean Koonz, LCSW CSAC
• Eric Christian Koski Sr., PHARMD
• Christina B Kosterman, RN
• Kathleen M. Kostroski, RN

• Ophthalmology Physician in Racine, WI
• Providers in Racine, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.