Individual provider Active NPI

Andrew P Baniukiewicz, MD

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1629029350
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
43022-020 Issued in WI
Practice address
10625 W North Ave
102
Milwaukee, WI 53226-2315
Phone
(414) 877-5350
Fax
(414) 877-5360
NPI assigned
May 15, 2006
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 43022-020 WI Primary

Addresses

Primary practice location

10625 W North Ave
102
Milwaukee, WI 53226-2315

Mailing address

10625 W North Ave
102
Milwaukee, WI 53226-2315
Phone (414) 877-5350

Other identifiers 1

IdentifierTypeStateIssuer
34076600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43022-020WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Past Accepting new patients
Integrated Therapeutic Massage LLC PastSince Aug 1, 2021 Accepting new patients
Racine Emergency Physicians, S.C. Emergency Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: abaniukiewicz220625@direct.myadvocateaurora.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1629029350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE",
            "address_2": "102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE",
            "address_2": "102",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350",
            "fax_number": "414-877-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANIUKIEWICZ",
        "first_name": "ANDREW",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "43022-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34076600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.