Individual provider Active NPI

Scott D. Fenske, M.D.

  • Internal Medicine Physician
  • New Berlin, WI
National Provider Identifier
1619960309
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26964 Issued in WI
Practice address
14555 W National Ave
Suite 170
New Berlin, WI 53151-4494
Phone
(262) 827-3636
Fax
(262) 827-3626
NPI assigned
Aug 26, 2005
Last updated
Dec 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26964 WI Primary

Addresses

Primary practice location

14555 W National Ave
Suite 170
New Berlin, WI 53151-4494

Mailing address

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Other identifiers 2

IdentifierTypeStateIssuer
P00627750OtherWIRR MEDICARE
30808000MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sfenske422@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 WI
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
I20050615000344 WI Practitioner - Internal Medicine 8325951015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1055 N Mayfair Rd
Wauwatosa, WI 53226-3436
Phone (414) 476-8450

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

14555 W National Ave
Suite 120
New Berlin, WI 53151-4494
Phone (262) 827-2955

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

215 W Washington St
Grafton, WI 53024-1700
Phone (262) 375-3700

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

3289 N Mayfair Rd
Wauwatosa, WI 53222-3203
Phone (414) 771-7900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26964WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince Sep 1, 2008 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 1, 2008 Accepting new patients
Aurora Medical Group, Inc. PastSince Jun 1, 2015 Accepting new patients
Commonwealth Medical Group, LLC Internal Medicine PastSince Mar 1, 1998 Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

14555 W National Ave
Ste 170
New Berlin, WI 53151
Phone (262) 827-3636

Interoperability endpoints

  • Direct secure messaging: sfenske422@direct.myadvocateaurora.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1619960309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W GOOD HOPE RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092042",
            "telephone_number": "414-352-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 W NATIONAL AVE",
            "address_2": "SUITE 170",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531514494",
            "telephone_number": "262-827-3636",
            "fax_number": "262-827-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSKE",
        "first_name": "SCOTT",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "26964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00627750",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30808000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfenske422@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14555 W National Ave",
            "address_2": "Suite 170",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531514494",
            "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": "14555 W National Ave",
            "address_2": "Suite 170",
            "city": "New Berlin",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531514494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

Verify at the official NPI Registry.