Individual provider Active NPI

Nicholas Z Pryomski, M.D.

  • Family Medicine Physician
  • Mount Pleasant, WI
National Provider Identifier
1760897912
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
67376 Issued in WI
Practice address
6611 Spring St
Mount Pleasant, WI 53406-2632
Phone
(262) 504-3100
NPI assigned
Jun 26, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 67376 WI Primary

Addresses

Primary practice location

6611 Spring St
Mount Pleasant, WI 53406-2632

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 504-3100

Other practice location 1

8400 Washington Ave
Mount Pleasant, WI 53406-3735
Phone (262) 321-3000

Other practice location 2

650 Stewart Rd
Monroe, MI 48162-4222
Phone (734) 240-8430

Other identifiers 1

IdentifierTypeStateIssuer
1043638083MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address npryomski189593@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20170712003197 WI Practitioner - Family Practice 9335418946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Aamg Reach PLLCGroup PAC ID 5597133264, 52 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

8400 Washington Ave
Mount Pleasant, WI 53406-3735
Phone (262) 321-3000

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Ascension at Home Home health agency, Milwaukee, WI, CCN 527187
  • Aurora at Home Hospice, Wauwatosa, WI, CCN 521528
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Ascension All Saints Hospital Hospital, Racine, WI, CCN 520096
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67376WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 31, 2017 Accepting new patients
Aamg Reach PLLC Family Medicine CurrentSince Sep 21, 2022 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 31, 2017 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

6611 Spring St
Mount Pleasant, WI 53406
Phone (262) 504-3100

8400 Washington Ave
Mount Pleasant, WI 53406
Phone (262) 231-3000

Organizations & group practices 5

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 7

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": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1760897912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-504-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6611 SPRING ST",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534062632",
            "telephone_number": "262-504-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8400 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "534063735",
            "country_code": "US",
            "telephone_number": "262-321-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 Stewart Rd",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "MI",
            "postal_code": "481624222",
            "country_code": "US",
            "telephone_number": "734-240-8430",
            "fax_number": "734-240-8495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRYOMSKI",
        "first_name": "NICHOLAS",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "67376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043638083",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "npryomski189593@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8400 Washington Ave",
            "city": "Mount Pleasant",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534063735",
            "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": "8400 Washington Ave",
            "city": "Mount Pleasant",
            "state": "WI",
            "country_code": "US",
            "postal_code": "534063735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.