Dominic Patrick Porubsky

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2448 S 102ND St Ste 200
West Allis, WI 53227-2141

Phone

(414) 327-3000

NPI assigned

Jun 24, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rogers Memorial Hospital Incorporated

  • Psychiatric Hospital
  • Oconomowoc, WI
  • NPI 1053329581
  NPD

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1558093997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 ANITA CT",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530454229",
            "telephone_number": "262-765-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 S 102ND ST STE 200",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272141",
            "telephone_number": "414-327-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORUBSKY",
        "first_name": "DOMINIC",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark D Plumb, M.D.
• Catherine Jean Podolske, APSW
• Olivia Louise Pogodzinski, DDS
• Sonia Polston, APSW
• Nicole Susan Ponda, DPT
• Carol Wiltse Potts, MD
• Kathleen Mary Powell Mattioli, MD
• Monica Prado Leon
• Trina M Pratte, PT
• Premier Care of Wisconsin, LLC.

• Student in an Organized Health Care Education/Training Program in West Allis, WI
• Providers in West Allis, WI by specialty
• Student in an Organized Health Care Education/Training Program in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.