Alec Samuel Small, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

81508-21 Issued in WI

Practice address

10400 75TH St
Kenosha, WI 53142-7884

Phone

(262) 948-5600

NPI assigned

Apr 1, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asmall115336@uihealth.direct-ci.com
• Direct secure messaging: asmall305970@direct.myadvocateaurora.org

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378
  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Advocate Health & Hospitals Corp.

  dba Bethany Hospital

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1750315545
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Kenosha, WI
  • NPI 1225156888
  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  dba Advocate Lutheran General Hospital

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1700464526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S WOOD ST RM 469A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 75TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427884",
            "telephone_number": "262-948-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Dempster St",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681143",
            "country_code": "US",
            "telephone_number": "847-723-5150",
            "fax_number": "847-318-2949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMALL",
        "first_name": "ALEC",
        "middle_name": "SAMUEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.166609",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81508-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100278001",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asmall305970@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1775 Dempster St",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna M Slawny, M.S.
• Michael Josef Slimack, D.O.
• Nyssa Slimack, APNP
• Chad E Sloden, D.C
• Emily A Slominski, LCSW
• Dennis Smerko, CPO, LPO
• Smile Doctors LTD
• Lisa Smith-Nowak, RN
• Abigail L Smith, LAT
• David Smith, LPC

• Emergency Medicine Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Emergency Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.