Individual provider Active NPI

David Thomas Koenig, DO

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1346739042
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
71835-21 Issued in WI
Practice address
9200 W Wisconsin Ave # 1P
Milwaukee, WI 53226-3522
Phone
(414) 805-6450
NPI assigned
May 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 71835-21 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave # 1P
Milwaukee, WI 53226-3522

Mailing address

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 805-6450

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
I20210810000007 WI Practitioner - Emergency Medicine 3870928757 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ermed, SCGroup PAC ID 5092608554, 45 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6588

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

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ermed, SC Emergency Medicine CurrentSince Jul 28, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Milwaukee Radiologists LTD Current Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

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

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

3400 Union Ave
Sheboygan, WI 53081
Phone (920) 802-2100

Organizations & group practices 4

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 4

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1346739042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 W WATERTOWN PLANK RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263548",
            "telephone_number": "414-805-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE # 1P",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "DAVID",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-08",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "71835-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.