Surgical Associates of Kenosha, SC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

16095 Issued in WI

Legal business name

SURGICAL ASSOCIATES OF KENOSHA, SC

Practice address

6308 8TH Ave Ste 302
Kenosha, WI 53143-5031

Phone

(262) 656-8217

NPI assigned

Mar 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Roger T. Pacanowski, M. D.

Title

President

Phone

(262) 652-5370

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1417222076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 2ND AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436067",
            "telephone_number": "262-652-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE STE 302",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF KENOSHA, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "PACANOWSKI",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-652-5370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "16095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sunstone Assisted Living LLC
• Superior Health and Wellness of Gurnee, LTD
• Suresh R Naik MD SC
• Suresh R Naikmd SC
• Surgical Associates of Kenosha S. C.
• Mikayla Rose Surprenant
• Surya Medical Group SC
• Susan M. Cable, DDS, SC (Susan M Cable DDS)
• Lindsay Swartz, RD
• Purnima Swearingen, DDSMSD

• Surgery Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.