Kim T Duczak, APNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1544-033 Issued in WI

Practice address

818 Forrest LN
Waterford, WI 53185

Phone

(262) 514-3700

Fax

(262) 514-3865

NPI assigned

Aug 20, 2006

Last updated

Dec 1, 2021By 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 2

Addresses

Other names 1

• Kim Tracy Nauta Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kduczak45167@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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Union Grove, WI
  • NPI 1245440601
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1346355542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "262-514-3700",
            "fax_number": "262-514-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 FORREST LN",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "53185",
            "telephone_number": "262-514-3700",
            "fax_number": "262-514-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCZAK",
        "first_name": "KIM",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "1544-033",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "80028-030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kduczak45167@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "818 Forrest Ln",
            "city": "Waterford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53185",
            "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": "818 Forrest Ln",
            "city": "Waterford",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "NAUTA",
            "middle_name": "TRACY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lenore Marie Desouto-Thren, LPN
• Pavneet Kaur Dhillon, PHARMD
• Christine M Dignan, MD
• Erin Emily Droy, MD
• Cathy Jo Duchow-Cross, FNP
• Kelli Dunham, RD
• Lynette Marie Edwards, CCC-SLP
• Lynn Ellen Erickson-Meier, NBS-HIS #623
• Eye Wisconsin LLC
• Family Vision & Contact Lens Centers, S.C.

• Nurse Practitioner in Waterford, WI
• Providers in Waterford, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.