Individual provider Active NPI

Kenneth Brian Lewoczko, M.D.

  • Otolaryngology Physician
  • Madison, WI
National Provider Identifier
1700145091
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
61185 Issued in WI
Practice address
600 Highland Ave., H4/831
Uw Hospital and Clinics
Madison, WI 53792
Phone
(608) 263-0192
NPI assigned
May 8, 2012
Last updated
Mar 29, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 61185 WI Primary

Addresses

Primary practice location

600 Highland Ave., H4/831
Uw Hospital and Clinics
Madison, WI 53792

Mailing address

600 Highland Ave., H4/831
Uw Hospital and Clinics
Madison, WI 53792
Phone (608) 263-0192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20171017000768 TN Practitioner - Otolaryngology 9335371657

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Tennessee, HSC, College of Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2340 Knob Creek Rd
Suite 704
Johnson City, TN 37604-2977

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.89 of 100Reported as group
Quality
62.92
Improvement activities
40
Cost
79.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61185WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Associates PC Otolaryngology CurrentSince Jun 20, 2017 Accepting new patients

Locations

2340 Knob Creek Rd
Ste 704
Johnson City, TN 37604
Phone (423) 929-9101

Interoperability endpoints

  • Direct secure messaging: kenlewoczko@entatn.allscriptsdirect.net

Organizations & group practices 1

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 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": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1700145091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE., H4/831",
            "address_2": "UW HOSPITAL AND CLINICS",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53792",
            "telephone_number": "608-263-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE., H4/831",
            "address_2": "UW HOSPITAL AND CLINICS",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53792",
            "telephone_number": "608-263-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWOCZKO",
        "first_name": "KENNETH",
        "middle_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-08",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "61185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.