Active NPI
Nicholas Michael Kolanko, M.D.
- Diagnostic Radiology Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 67438-20
- Practice address
- 1500 E Medical Center Dr
2ND Floor Taubman Center Recp a
Ann Arbor, MI 48109-5326 - Phone
- (734) 936-5850
- NPI assigned
- Aug 5, 2008
- Last updated
- Feb 1, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 50104-20 | WI | |
| Diagnostic Radiology Physician | 2085R0202X | 4301098589 | MI | |
| Diagnostic Radiology Physician | 2085R0202X | 125052322 | IL | |
| Diagnostic Radiology Physician | 2085R0202X | 67438-20 | WI | Primary |
Addresses
Primary practice location
1500 E Medical Center Dr
2ND Floor Taubman Center Recp a
Ann Arbor, MI 48109-5326
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Other practice location 1
1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125052322 | Other | IL | ILLINOIS LICENSE NUMBER, TEMPORARY PHYSICIAN LICENSE |
| 1427214857 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nkolanko423277@direct-ehr-ssmhc.com | Direct | |
| FHIR URL | https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Creighton University School of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1211 Fish Hatchery Rd
Madison, WI 53715-1909
Phone (608) 252-8000
12333 Briarbush LN
Potomac, MD 20854-1032
Phone (614) 340-7740
1313 Fish Hatchery Rd
2B
Madison, WI 53715-1911
Phone (608) 252-8000
2223 Lime Kiln Rd
Green Bay, WI 54311-6213
2223 Lime Kiln Rd
Suite 1
Green Bay, WI 54311-6238
Phone (920) 430-8113
333 N Commercial St
Suite 150
Neenah, WI 54956-2670
Phone (920) 886-7525
835 S Van Buren St
Green Bay, WI 54301-3526
Phone (920) 433-0111
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125052322 | IL | MD | Diagnostic Radiology Physician |
| 4301098589 | MI | MD | Diagnostic Radiology Physician |
| 50104-20 | WI | MD | Diagnostic Radiology Physician |
| 67438-20 | WI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Current | Accepting new patients | |
| St. Nicholas Hospital-Sisters of the Third Order of St Francis | Family Medicine | Current | Accepting new patients |
| St Vincent Hospital-Hospital Sisters-Third Order of St Francis | Family Medicine | Current | Accepting new patients |
| Beloit Radiology LTD | Diagnostic Radiology | Current | Accepting new patients |
| Radiology Regional Center P a | Diagnostic Radiology | Current | Accepting new patients |
| Green Bay Radiology SC | Diagnostic Radiology | Current | Accepting new patients |
| St Nicholas Hospital-Sisters of the Third Order of St Francis | Current | Accepting new patients | |
| GBR Sheboygan LLC | Diagnostic Radiology | Current | Accepting new patients |
| Radiology Associates of the Fox Valley, SC | Diagnostic Radiology | Current | Accepting new patients |
| St. Nicholas Hospital-Sisters of the Third Order of St Francis | Current | Accepting new patients | |
| Orthopedic & Sports Medicine Specialists of Green Bay, SC | Current | Accepting new patients | |
| Madison Radiologists S C | Diagnostic Radiology | Current | Accepting new patients |
| Radiology Regional Center, PA | Diagnostic Radiology | Past | Accepting new patients |
| Radiology Regional Center, PA | Diagnostic Radiology | Past | Accepting new patients |
Locations (25 of 28)
9776 Bonita Beach Rd SE
Bonita Springs, FL 34135
Phone (239) 444-2200
1708 Cape Coral Pkwy W
Ste 3
Cape Coral, FL 33914
Phone (239) 541-3800
805 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 242-8010
10201 Arcos Ave
Ste 101
Estero, FL 33928
Phone (239) 444-5800
14551 Hope Center Loop
Ste 100
Fort Myers, FL 33912
Phone (399) 362-3162
3660 Broadway
Fort Myers, FL 33901
Phone (239) 424-1449
6100 Winkler Rd
Fort Myers, FL 33919
6140 Winkler Rd
Fort Myers, FL 33919
1110 Lee Blvd
Lehigh Acres, FL 33936
Phone (239) 344-1000
700 Goodlette Rd
Naples, FL 34102
Phone (239) 430-1400
18300 Murdock Cir
Bldg 15
Port Charlotte, FL 33948
Phone (941) 255-7901
6600 University Pkwy
Ste 102
Sarasota, FL 34240
Phone (941) 378-3231
100 E Campus View Blvd
Ste 100
Columbus, OH 43235
Phone (412) 359-8743
1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011
800 Clay St
Darlington, WI 53530
Phone (608) 776-4466
800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200
2223 Lime Kiln Rd
Ste 1
Green Bay, WI 54311
Phone (920) 468-0246
2941 S Ridge Rd
Green Bay, WI 54304
Phone (920) 336-4096
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
1211 Fish Hatchery Rd
Madison, WI 53715
Phone (608) 252-8000
1211 Fish Hatchery Rd
#2B
Madison, WI 53715
Phone (608) 252-8000
1931 Marinette Ave
Marinette, WI 54143
Phone (715) 735-5500
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
1205 West American Dr
Neenah, WI 54956
Phone (920) 727-8144
333 N Commercial St
Ste 150
Neenah, WI 54956
Phone (920) 722-3444
Networks
- Freedom Health HMO Network
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/0cda6ed7-9e18-4112-ab11-d5a45a40c8d5/
- nkolanko423277@direct-ehr-ssmhc.com
Organizations & group practices 15
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.
-
- Specialist
- Green Bay, WI
- NPI 1760670145
-
- Diagnostic Radiology Physician
- Neenah, WI
- NPI 1477539443
DC
-
dba SSM Health Dean Medical Group
- Allergy & Immunology Physician
- Madison, WI
- NPI 1053358846
-
dba St. Nicholas Hospital
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1447737762
-
dba Prevea Health
- Durable Medical Equipment & Medical Supplies
- Green Bay, WI
- NPI 1245042530
-
dba Prevea Health
- General Practice Physician
- Green Bay, WI
- NPI 1285613638
Family Medicine
-
dba Prevea Sheboygan Health Center
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1275799413
Family Medicine
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Door County Medical Center
- Critical Access Hospital
- Sturgeon Bay, WI
- NPI 1093743874
-
dba Door County Medical Center Lab
- Clinical Medical Laboratory
- Sturgeon Bay, WI
- NPI 1811090285
Hospital
-
dba SSM Health St. Mary's Hospital-Madison
- General Acute Care Hospital
- Madison, WI
- NPI 1184621211
-
- General Acute Care Hospital
- Green Bay, WI
- NPI 1649246877
-
dba St. Nicholas Hospital Renal Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Sheboygan, WI
- NPI 1427009992
Hospital
-
dba St Vincent Hospital
- General Acute Care Hospital
- Green Bay, WI
- NPI 1114908001
-
dba St Nicholas Hospital
- General Acute Care Hospital
- Sheboygan, WI
- NPI 1730184342
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Sheboygan, WI
- NPI 1831784636
Hospital
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Green Bay, WI
- NPI 1184004236
Hospital
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Oconto Falls, WI
- NPI 1750760740
Hospital
-
dba St. Vincent Regional Cancer Center
- Hematology & Oncology Physician
- Sturgeon Bay, WI
- NPI 1760861751
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1427214857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"address_2": "2ND FLOOR TAUBMAN CENTER RECP A",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095326",
"telephone_number": "734-936-5850"
}
],
"practiceLocations": [
{
"address_1": "1211 Fish Hatchery Rd",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "537151909",
"country_code": "US",
"telephone_number": "608-252-8000",
"fax_number": "608-258-6933",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KOLANKO",
"first_name": "NICHOLAS",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-05",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "50104-20",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301098589",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "125052322",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "67438-20",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS LICENSE NUMBER, TEMPORARY PHYSICIAN LICENSE",
"identifier": "125052322",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1427214857",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nkolanko423277@direct-ehr-ssmhc.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "nkolanko423277@direct-ehr-ssmhc.com",
"address_1": "1211 Fish Hatchery Rd",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151909",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "FHIR API",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCD",
"address_1": "1211 Fish Hatchery Rd",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537151909",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.