Kenneth Joseph Pechman, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

24239020 Issued in WI

Practice address

2806 Riverview Dr
Green Bay, WI 54313-6717

Phone

(920) 498-7546

Fax

(920) 569-4129

NPI assigned

Jul 20, 2005

Reactivated

Mar 29, 2006

Last updated

Apr 12, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kenneth.pechman@forefrontdermatology.emadirect.md

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744416000000",
    "number": "1417956525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-683-5278",
            "fax_number": "920-686-9674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 RIVERVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543136717",
            "telephone_number": "920-498-7546",
            "fax_number": "920-569-4129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECHMAN",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2025-04-12",
        "certification_date": "2025-04-12",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": "24239020",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "24239020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kenneth.Pechman@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "2806 Riverview Dr",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543136717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Josh Payne, PTA
• Roxann Pazdera, LCSW
• Kerry Jo Pearce, DPT
• Kendra Oswald Pearson, MPT
• Amanda Pecha, LCSW, CSAC, CSIT
• Brenda Lee Peebles, PTA
• Cory W Peed, PT
• Ryan M Peirce, M.D.
• Cindy L Pelnar, RD
• Sandra Renee Pelnar, C.N.M., W.H.N.P.

• Dermatology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; 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.

Verify at the official NPI Registry.