Individual provider Active NPI

Daniel Michael Drzewiecki, MS, MPH, PA-C

  • Physician Assistant
  • West Allis, WI
National Provider Identifier
1639796790
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5552-023 Issued in WI
Practice address
2424 S 90TH St
West Allis, WI 53227-2455
Phone
(414) 328-8750
NPI assigned
Jul 6, 2020
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X 5552-023 WI Primary

Addresses

Primary practice location

2424 S 90TH St
West Allis, WI 53227-2455

Mailing address

2424 S 90TH St
West Allis, WI 53227-2455
Phone (414) 328-8750

Other practice location 1

3333 Green Bay Rd
College of Health Professions: Physician Assistant Dept
North Chicago, IL 60064-3037
Phone (847) 578-8825

Other identifiers 1

IdentifierTypeStateIssuer
100181219MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address ddrzewiecki279063@direct.myadvocateaurora.org Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211004000805 WI Practitioner - Physician Assistant 7214335496 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

2424 S 90TH St
West Allis, WI 53227-2455
Phone (414) 328-8630

4448 W Loomis Rd
Greenfield, WI 53220-4800
Phone (414) 281-5150

6901 W Edgerton Ave
Milwaukee, WI 53220-4420
Phone (414) 421-8400

8901 W Lincoln Ave
West Allis, WI 53227-2409
Phone (414) 329-5930

Hospital & facility affiliations

  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
5552-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Oct 15, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 15, 2021 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Oct 15, 2021 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 15, 2021 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Oct 15, 2021 Accepting new patients
Aurora Medical Group, Inc. Past 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

4448 W Loomis Rd
Ste 204
Milwaukee, WI 53220
Phone (414) 281-1688

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

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

6901 W Edgerton Ave
Milwaukee, WI 53220
Phone (414) 325-5244

9000 W Sura Ln
Milwaukee, WI 53228
Phone (414) 246-6500

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

2424 S 90th St
West Allis, WI 53227
Phone (414) 321-2255

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: ddrzewiecki279063@direct.myadvocateaurora.org

Organizations & group practices 6

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 4

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": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1639796790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Green Bay Rd",
            "address_2": "College of Health Professions: Physician Assistant Dept",
            "address_purpose": "LOCATION",
            "city": "North Chicago",
            "state": "IL",
            "postal_code": "600643037",
            "country_code": "US",
            "telephone_number": "847-578-8825",
            "fax_number": "847-578-8690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRZEWIECKI",
        "first_name": "DANIEL",
        "middle_name": "MICHAEL",
        "credential": "MS, MPH, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-06",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5552-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100181219",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2424 S 90th St",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddrzewiecki279063@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2424 S 90th St",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.