Active NPI
Kristopher J Selke, DO
- Interventional Cardiology Physician
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 74659
- Practice address
- 2845 Greenbrier Rd
Green Bay, WI 54311-6519 - Phone
- (920) 288-8000
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 5101016361 | MI | |
| Cardiovascular Disease Physician | 207RC0000X | 19778-875 | WI | |
| Cardiovascular Disease Physician | 207RC0000X | 51010116361 | MI | |
| Interventional Cardiology Physician | 207RI0011X | 51010116361 | MI | |
| Interventional Cardiology Physician | 207RI0011X | 74659 | WI | Primary |
Addresses
Primary practice location
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Mailing address
3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (920) 288-8000
Other practice location 1
1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 731-8900
Other practice location 2
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-4183
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100140377 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kselke360547@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- Lake Erie College of Osteopathic Medicine, Erie, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8000
Hospital & facility affiliations
- Aurora Baycare Medical Ctr
- Door County Medical Center
- Aurora Medical Ctr Manitowoc County
- Aurora Medical Center Bay Area
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101016361 | MI | MD | Internal Medicine Physician |
| 19778-875 | WI | MD | Cardiovascular Disease Physician |
| 51010116361 | MI | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baycare Aurora, LLC | Cardiovascular Disease | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Trinity Health - Michigan | Past | Accepting new patients | |
| Saint Mary'S Health Services | Past | Accepting new patients |
Locations
1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
2845 Greenbrier Rd
Ste 310
Green Bay, WI 54311
Phone (920) 288-8300
2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388
2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000
1500 Arbor Way
Kaukauna, WI 54130
Phone (877) 229-2273
3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
Interoperability endpoints
- kselke360547@direct.myadvocateaurora.org
- kselke301651@direct.thedacare.org
Organizations & group practices 5
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
-
- Federally Qualified Health Center (FQHC)
- Grand Rapids, MI
- NPI 1902002272
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Two Rivers, WI
- NPI 1477508687
-
- General Acute Care Hospital
- Marinette, WI
- NPI 1043397177
-
- Clinical Medical Laboratory
- Marinette, WI
- NPI 1083791115
Hospital
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1255387726
-
- Critical Access Hospital
- Sturgeon Bay, WI
- NPI 1093743874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677024000000",
"number": "1376747733",
"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": "920-288-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2845 GREENBRIER RD",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543116519",
"telephone_number": "920-288-8000"
}
],
"practiceLocations": [
{
"address_1": "1818 N Meade St",
"address_purpose": "LOCATION",
"city": "Appleton",
"state": "WI",
"postal_code": "549113454",
"country_code": "US",
"telephone_number": "920-731-8900",
"fax_number": "920-738-5369",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-4183",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SELKE",
"first_name": "KRISTOPHER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2023-02-22",
"certification_date": "2023-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "5101016361",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "WI",
"license": "19778-875",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MI",
"license": "51010116361",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "MI",
"license": "51010116361",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "WI",
"license": "74659",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100140377",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kselke360547@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2845 Greenbrier Rd",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543116519",
"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": "2845 Greenbrier Rd",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543116519",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.