Theresa Jean Niemczyk, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

384-23 Issued in WI

Practice address

4131 W Loomis Rd
Suite 300
Greenfield, WI 53221-2057

Phone

(414) 325-7246

Fax

(414) 325-3770

NPI assigned

Nov 17, 2010

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Advanced Pain Management SC

  • Pain Medicine Physician
  • Greenfield, WI
  • NPI 1770506669
  NPD
• Advanced Pain Management, SC

  • Durable Medical Equipment & Medical Supplies
  • Evansville, IN
  • NPI 1669832655
  NPD

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1366744716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "SUITE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "SUITE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMCZYK",
        "first_name": "THERESA",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "384-023",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "384-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Nevinski
• Phoebe Newstrom
• Stacy Lauren Newton, RN
• Leart Neziri, MD
• Joseph A. Nicholas, M.D.
• Donald David Nimmer, M.D.
• Unknown Niroys, DPT
• Lanae K. Noah, O.T.
• Asayca Noblin
• Valentino Nokovic, PTA

• Physician Assistant in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.