Individual provider Active NPI

Caroline Eleonora Bednarski, MD

  • Obstetrics & Gynecology Physician
  • Pleasant Prairie, WI
National Provider Identifier
1407218894
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
73322-20 Issued in WI
Practice address
9555 76TH St # 4105
Pleasant Prairie, WI 53158-1984
Phone
(262) 577-8080
NPI assigned
Mar 24, 2016
Last updated
Jun 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036.149808 IL
Obstetrics & Gynecology Physician 207V00000X 125.068336 IL
Obstetrics & Gynecology Physician 207V00000X 73322-20 WI Primary

Addresses

Primary practice location

9555 76TH St # 4105
Pleasant Prairie, WI 53158-1984

Mailing address

9555 76TH St # 4105
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8080

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
I20200819001276 WI Practitioner - Obstetrics/Gynecology 4981987542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.149808ILMDObstetrics & Gynecology Physician
125.068336ILMDObstetrics & Gynecology Physician
73322-20WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert South, Inc. CurrentSince Aug 11, 2020 Accepting new patients
Froedtert South, Inc. Past Accepting new patients

Locations

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

9555 76th St
#4105
Pleasant Prairie, WI 53158
Phone (262) 577-8080

9555 76th St
Ste 4105
Pleasant Prairie, WI 53158
Phone (262) 577-8080

Interoperability endpoints

  • Direct secure messaging: cbednarski396604@direct.froedtert.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1407218894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 76TH ST # 4105",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-577-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 76TH ST # 4105",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531581984",
            "telephone_number": "262-577-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDNARSKI",
        "first_name": "CAROLINE",
        "middle_name": "ELEONORA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.149808",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125.068336",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "73322-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

Verify at the official NPI Registry.