Individual provider Active NPI

John K Choi, MD

  • Pain Medicine (Anesthesiology) Physician
  • Fond Du Lac, WI
National Provider Identifier
1679557151
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
29915 Issued in WI
Practice address
421 Camelot Dr
Fond Du Lac, WI 54935-8335
Phone
(920) 926-4939
Fax
(920) 926-5999
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 29915 WI Primary

Addresses

Primary practice location

421 Camelot Dr
Fond Du Lac, WI 54935-8335

Mailing address

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8340

Other identifiers 2

IdentifierTypeStateIssuer
14567OtherWIDEAN
31493700MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jchoi330905@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

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
I20040119000296 WI Practitioner - Pain ManagementPractitioner - Anesthesiology 4789585183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Medical College of Wisconsin, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

130 Corporate Dr
Beaver Dam, WI 53916-3116
Phone (920) 887-3102

360 S Mountin Dr
Mayville, WI 53050-1498
Phone (920) 387-2111

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 923-7400

421 Camelot Dr
Fond Du Lac, WI 54935-8335
Phone (920) 926-8616

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 929-2300

608 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6800

620 W Brown St
Waupun, WI 53963-1702
Phone (920) 324-6531

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29915WIMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare Inc CurrentSince Dec 1, 2003 Accepting new patients
Agnesian Healthcare Inc CurrentSince Dec 1, 2003 Accepting new patients
Agnesian Healthcare, Inc Current Accepting new patients

Locations

421 Camelot Dr
Fond du Lac, WI 54935
Phone (920) 923-7940

420 E Division St
Ste 4
Fond du Lac, WI 54935

430 E Division St
Ste 4
Fond du Lac, WI 54935
Phone (920) 926-2300

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

620 W Brown St
Ste 4
Waupun, WI 53963
Phone (920) 926-8332

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

Interoperability endpoints

  • Direct secure messaging: jchoi330905@direct-ehr-ssmhc.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1679557151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 CAMELOT DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549358335",
            "telephone_number": "920-926-4939",
            "fax_number": "920-926-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JOHN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WI",
            "license": "29915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN",
            "identifier": "14567",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31493700",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jchoi330905@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jchoi330905@direct-ehr-ssmhc.com",
            "address_1": "421 Camelot Dr",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549358335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "421 Camelot Dr",
            "city": "Fond Du Lac",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549358335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.