Individual provider Active NPI

Nicholas Michael Kolanko, M.D.

  • Diagnostic Radiology Physician
  • Ann Arbor, MI
National Provider Identifier
1427214857
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
67438-20 Issued in WI
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, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
125052322OtherILILLINOIS LICENSE NUMBER, TEMPORARY PHYSICIAN LICENSE
1427214857MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
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, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170703001008 WI Practitioner - Diagnostic Radiology 4880863034 Reassigns benefits to 8 organizations
I20240806004179 DC Practitioner - Diagnostic Radiology 4880863034 Reassigns benefits to 5 organizations

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
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians
Radiology Associates of the Fox Valley SCGroup PAC ID 0446152748, 73 clinicians
Madison Radiologists S CGroup PAC ID 1951209311, 58 clinicians
GBR Sheboygan LLCGroup PAC ID 1951341064, 22 clinicians
Green Bay Radiology SCGroup PAC ID 7113908310, 24 clinicians

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

LicenseStateTypeSpecialty
125052322ILMDDiagnostic Radiology Physician
4301098589MIMDDiagnostic Radiology Physician
50104-20WIMDDiagnostic Radiology Physician
67438-20WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jun 19, 2017 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 CurrentSince Jun 19, 2017 Accepting new patients
Beloit Radiology LTD Diagnostic Radiology CurrentSince Feb 21, 2022 Accepting new patients
Radiology Regional Center P a Diagnostic Radiology CurrentSince Feb 28, 2024 Accepting new patients
Green Bay Radiology SC Diagnostic Radiology CurrentSince Jun 26, 2017 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Oct 31, 2017 Accepting new patients
GBR Sheboygan LLC Diagnostic Radiology CurrentSince Jun 26, 2017 Accepting new patients
Radiology Associates of the Fox Valley, SC Diagnostic Radiology CurrentSince Nov 1, 2022 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Oct 31, 2017 Accepting new patients
Orthopedic & Sports Medicine Specialists of Green Bay, SC CurrentSince Jul 12, 2017 Accepting new patients
Madison Radiologists S C Diagnostic Radiology CurrentSince Feb 14, 2022 Accepting new patients
Radiology Regional Center, PA Diagnostic Radiology PastSince Aug 28, 2021 Accepting new patients
Radiology Regional Center, PA Diagnostic Radiology PastSince Aug 28, 2021 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

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0cda6ed7-9e18-4112-ab11-d5a45a40c8d5/
  • Direct secure messaging: 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.

View all 15

Hospital & facility affiliations 11

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": "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

Verify at the official NPI Registry.