Individual provider Active NPI

Michael Didinsky, DO

  • Orthopaedic Surgery of the Spine Physician
  • Kenosha, WI
National Provider Identifier
1316928336
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
48213 Issued in WI
Practice address
7401 104TH Ave
Suite 110
Kenosha, WI 53142-7845
Phone
(262) 764-5595
Fax
(262) 764-9314
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 48213 WI
Orthopaedic Surgery of the Spine Physician 207XS0117X 48213 WI Primary

Addresses

Primary practice location

7401 104TH Ave
Suite 110
Kenosha, WI 53142-7845

Mailing address

7401 104TH Ave
Suite 110
Kenosha, WI 53142-7845
Phone (262) 764-5595

Other identifiers 1

IdentifierTypeStateIssuer
43521500MedicaidWI

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
I20050822000777 WI Practitioner - Orthopedic Surgery 9830170109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Midwestern University, Chicago College of Osteopathic Med, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians
Comprehensive Orthopaedics SCGroup PAC ID 3375445497, 21 clinicians

Practice addresses (Care Compare)

10222 74TH St
Kenosha, WI 53142-6810
Phone (262) 925-5020

1757 B Milwaukee Avnue
Burlington, WI 53105-9458
Phone (262) 764-5595

3620 57TH Ave
Kenosha, WI 53144-4925
Phone (262) 925-5250

7200 Washington Ave
Mount Pleasant, WI 53406-6516
Phone (262) 583-0790

7740 S Lovers Lane Rd
Franklin, WI 53132-2211
Phone (419) 221-6717

9809 39TH Ave
Pleasant Prairie, WI 53158-3733
Phone (262) 925-5080

Hospital & facility affiliations

  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score
22.7 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
75.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion112
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Laminectomy or laminotomy (partial removal of spine bones)61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3990AZMDPsychologist
48213WIMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Orthopaedics SC Orthopaedic Surgery CurrentSince Aug 22, 2005 Accepting new patients
Comprehensive Orthopaedics SC CurrentSince Aug 22, 2005 Accepting new patients

Locations

1757 Milwaukee Ave
#B
Burlington, WI 53105
Phone (262) 764-5595

7401 104th Ave
#110
Kenosha, WI 53142
Phone (262) 764-5595

6804 Green Bay Rd
Ste 108
Kenosha, WI 53142
Phone (262) 697-6323

7401 104th Ave
#100
Kenosha, WI 53142
Phone (262) 697-1006

Interoperability endpoints

  • Direct secure messaging: michael.didinsky.p1@direct.comportho.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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 2

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1316928336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 104TH AVE",
            "address_2": "SUITE 110",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427845",
            "telephone_number": "262-764-5595",
            "fax_number": "262-764-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 104TH AVE",
            "address_2": "SUITE 110",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427845",
            "telephone_number": "262-764-5595",
            "fax_number": "262-764-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIDINSKY",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "48213",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "WI",
            "license": "48213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43521500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.