Individual provider Active NPI

Korey Benjamin Kasper, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Pewaukee, WI
National Provider Identifier
1669854618
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
87110-20 Issued in WI
Practice address
N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone
(262) 303-5055
Fax
(262) 303-5057
NPI assigned
Jun 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 87110-20 WI Primary
Sports Medicine (Family Medicine) Physician 207QS0010X S4789 TX
Sports Medicine (Family Medicine) Physician 207QS0010X 29916 NE

Addresses

Primary practice location

N15W28300 Golf Rd
Pewaukee, WI 53072-4800

Mailing address

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Other practice location 1

3250 Zemke Ave Bldg 1078
Tampa, FL 33621-5023
Phone (813) 827-9650

Other identifiers 1

IdentifierTypeStateIssuer
100408586MedicaidWI

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
I20260430003908 WI Practitioner - Family PracticePractitioner - Sports Medicine 6002126430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

N15W28300 Golf Rd
Pewaukee, WI 53072-4800
Phone (262) 303-5055

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29916NEMDSports Medicine (Family Medicine) Physician
S4789TXMDSports Medicine (Family Medicine) Physician
87110-20WIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Wisconsin, SC CurrentSince Jun 5, 2026 Accepting new patients
Orthopaedic Associates of Wisconsin SC PastSince Jun 5, 2026 Accepting new patients

Locations

1231 S Rochester St
Ste 100
Mukwonago, WI 53149

N15W28300 Golf Rd
Pewaukee, WI 53072

Organizations & group practices 2

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1669854618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N15W28300 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724800",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N15W28300 GOLF RD",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530724800",
            "telephone_number": "262-303-5055",
            "fax_number": "262-303-5057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3250 Zemke Ave Bldg 1078",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336215023",
            "country_code": "US",
            "telephone_number": "813-827-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASPER",
        "first_name": "KOREY",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WI",
            "license": "87110-20",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "S4789",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NE",
            "license": "29916",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100408586",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

Verify at the official NPI Registry.