Individual provider Active NPI

Scott A Kunkel, D.O.

  • Emergency Medicine Physician
  • Sheboygan, WI
National Provider Identifier
1609187004
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
66197 Issued in WI
Practice address
2629 N 7TH St
Sheboygan, WI 53083-4932
Phone
(920) 451-5000
NPI assigned
Jun 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 66197 WI Primary
Emergency Medicine Physician 207P00000X 19505 CA

Addresses

Primary practice location

2629 N 7TH St
Sheboygan, WI 53083-4932

Mailing address

2629 N 7TH St
Sheboygan, WI 53083-4932
Phone (920) 451-5000

Other identifiers 1

IdentifierTypeStateIssuer
1609187004MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address skunkel187471@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20220714000192 CA Practitioner - Emergency Medicine 7315223971 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Services Medical Corporation CoronadoGroup PAC ID 3779904438, 26 clinicians

Practice addresses (Care Compare)

250 Prospect PL
Coronado, CA 92118-1943
Phone (858) 759-4765

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
19505CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America-California Emergency Medicine CurrentSince Jul 13, 2022 Accepting new patients
Palomar Emergency Physicians, Inc Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 13, 2022 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 13, 2022 Accepting new patients
Emergency Services Medical Corporation Coronado Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
The Medical College of Wisconsin, Inc. Emergency Medicine CurrentSince May 1, 2018 Accepting new patients

Locations

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

751 Medical Center Ct
#1182
Chula Vista, CA 91911

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

250 Prospect Pl
San Diego, CA 92118
Phone (619) 522-3600

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1609187004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "920-451-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "920-451-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNKEL",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "66197",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "19505",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609187004",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skunkel187471@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2629 N 7th St",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530834932",
            "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": "2629 N 7th St",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530834932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.