Nicholas A Akgulian, MD
Individual provider Active NPI Family Medicine Physician · Salem, WI
NPI 1740214980 · NPPES record last updated Mar 13, 2008
Key facts
- NPI
- 1740214980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 36326 (WI)
- Practice address
- 7322 236TH Ave
Salem, WI 53168-9664 - Phone
- (262) 577-8460
- Fax
- (262) 843-1424
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231207000533 | TX | Practitioner - Family Practice | 0446263768 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36326 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dilkon Medical Center | Current |
Accepting new patients | |
| Froedtert South, Inc. | Family Medicine | Current | Accepting new patients |
| Winslow Indian Health Care Center, Inc | Current | Accepting new patients | |
| Winslow Indian Health Care Center, Inc | Current |
Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients | |
| Kenosha Pathology Consultants | Past | Accepting new patients |
Locations
500 Indiana Ave
Winslow, AZ 86047
1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691
6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300
7322 236th Ave
Salem, WI 53168
Phone (262) 577-8460
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 36326 | WI | Yes |
Addresses
Primary practice location
7322 236TH Ave
Salem, WI 53168-9664
Mailing address
7322 236TH Ave
Salem, WI 53168-9664
Phone (262) 577-8460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32100000 | Medicaid | WI |
Other providers in Salem, WI
- Jessica Adamski
- Advantage Physical Therapy & Sports Rehab, LLC
- Advantage PT & Sports Rehab LLC
- Lisa Anderson
- Athletico LTD
- Aurora Medical Group, Inc.
- Brigg W Barsness
- Eliza Watkins Barter
All providers in Salem, WI · Family Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.