Samuel J Docksey, DO
Individual provider Active NPI Emergency Medicine Physician · Waupaca, WI
NPI 1578091500 · NPPES record last updated Feb 23, 2026
Key facts
- NPI
- 1578091500
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 81356 (WI)
- Practice address
- 800 Riverside Dr
Waupaca, WI 54981-1943 - Phone
- (715) 258-1041
- Fax
- (715) 258-1042
- NPI assigned
- Jun 4, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 14
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Midwestern University, Chicago College of Osteopathic Med, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ermed, SC
Thedacare Regional Medical Center - Appleton, Inc
Practice addresses (Care Compare)
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6588
755 W Johnson St
Fond Du Lac, WI 54935-2089
Phone (920) 913-4400
Hospital & facility affiliations
- Aurora St Lukes Medical Center
- West Allis Memorial Hospital
- Thedacare Medical Center - Berlin Inc
- Thedacare Regional Medical Center - Appleton Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240509003057 | WI | Practitioner - Emergency Medicine | 6901170182 | Reassigns benefits to 12 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
Locations
225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313
5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055
755 W Johnson St
Fond du Lac, WI 54935
Phone (920) 731-4101
3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590
3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229
1405 Mill St
New London, WI 54961
Phone (920) 531-2000
855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643
250 W 6th Ave
Oshkosh, WI 54902
Phone (920) 237-5000
100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161
800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000
601 Grove Ave
Wild Rose, WI 54984
Phone (888) 287-4488
Interoperability endpoints
- sdocksey398728@direct.myadvocateaurora.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 81356 | WI | Yes |
| Emergency Medicine Physician | 207P00000X | 05-43010 | KS |
Addresses
Primary practice location
800 Riverside Dr
Waupaca, WI 54981-1943
Mailing address
3 Neenah Ctr
Neenah, WI 54956-3070
Phone (920) 830-5900
Other practice location 1
2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-7229
Other practice location 2
650 Huebner Rd
Fort Riley, KS 66442-4030
Phone (706) 721-7005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100271864 | Medicaid | WI |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sdocksey398728@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
NPI Registry JSON
{
"created_epoch": "1496534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771804800000",
"number": "1578091500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 NEENAH CTR",
"city": "NEENAH",
"state": "WI",
"postal_code": "549563070",
"telephone_number": "920-830-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 RIVERSIDE DR",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549811943",
"telephone_number": "715-258-1041",
"fax_number": "715-258-1042"
}
],
"practiceLocations": [
{
"address_1": "2900 W Oklahoma Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532154330",
"country_code": "US",
"telephone_number": "414-649-7229",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "650 Huebner Rd",
"address_purpose": "LOCATION",
"city": "Fort Riley",
"state": "KS",
"postal_code": "664424030",
"country_code": "US",
"telephone_number": "706-721-7005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOCKSEY",
"first_name": "SAMUEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-04",
"last_updated": "2026-02-23",
"certification_date": "2026-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "81356",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "KS",
"license": "05-43010",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100271864",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sdocksey398728@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2900 W Oklahoma Ave",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532154330",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2900 W Oklahoma Ave",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532154330",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Waupaca, WI
- Robert Dent
- Debra Deporter
- Nancy E. Derkowski
- Francesca L Detrana
- Charles H Dinkel
- Stephanie Miller Doine
- Susan Dorsett
- Cara Dowsett
- Sarah C Durst
- Gary Edelman
All providers in Waupaca, WI · Emergency Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.