Mary J Reznicek, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

31908 Issued in WI

Practice address

8901 West Lincoln Avenue
West Allis, WI 53227-2477

Phone

(414) 328-7950

Fax

(414) 328-8505

NPI assigned

Jul 12, 2006

Last updated

Jan 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 4

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mreznicek2762@direct.myadvocateaurora.org

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.

• Great Lakes Pathologists SC

  • Anatomic Pathology & Clinical Pathology Physician
  • West Allis, WI
  • NPI 1689695934
  Medicare reassignment NPD
• A2Cl Services, LLC

  • Clinical Medical Laboratory
  • West Allis, WI
  • NPI 1710064811
  NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1306871710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WEST LINCOLN AVENUE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272477",
            "telephone_number": "414-328-7950",
            "fax_number": "414-328-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 WEST LINCOLN AVENUE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272477",
            "telephone_number": "414-328-7950",
            "fax_number": "414-328-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNICEK",
        "first_name": "MARY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "31908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "8901 West Lincoln Avenue",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mreznicek2762@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "8901 West Lincoln Avenue",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mreznicek2762@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "8901 West Lincoln Avenue",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272477",
            "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": "8901 West Lincoln Avenue",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Douglas Alan Reinertson, RRT
• Neil Reisinger, M.D.
• Frank Rewolinski, DPT
• Brian Joseph Reynolds, APNP/NP
• Angelica Reynosa
• Brett Rhode, M.D.
• Ava C Riccione
• Richard L Zussman DDS Ms SC
• Harold Kenneth Riches, D.O.
• Nancy J Richter, LCSW, CADCIII

• Anatomic Pathology & Clinical Pathology Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.