Individual provider Active NPI

Krisos D Spyratos, DO

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Kenosha, WI
National Provider Identifier
1780203901
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
81219 Issued in WI
Practice address
10400 75TH St
Kenosha, WI 53142-7884
Phone
(262) 948-5600
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 81219 WI
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 81219-21 WI
Student in an Organized Health Care Education/Training Program 390200000X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 81219 WI Primary

Addresses

Primary practice location

10400 75TH St
Kenosha, WI 53142-7884

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6000

Other practice location 2

3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 802-2100

Other identifiers 1

IdentifierTypeStateIssuer
100247993MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kspyratos373196@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
I20231220002898 WI Practitioner - Emergency Medicine 6305269259 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Campbell Univ School of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians

Practice addresses (Care Compare)

3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 828-2530

5900 S Lake Dr
Cudahy, WI 53110-3171
Phone (414) 489-4190

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue98
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
81219WIMDEmergency Medicine Physician
81219-21WIMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare Inc CurrentSince Sep 1, 2025 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Sep 1, 2025 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Sep 1, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Eastern Virginia Medical School Student in an Organized Health Care Education/Training Program PastSince Apr 1, 2020 Accepting new patients

Locations

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

1032 E Sumner St
Hartford, WI 53027
Phone (262) 670-4300

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

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

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

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

3400 Union Ave
Sheboygan, WI 53081
Phone (920) 802-2100

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

Interoperability endpoints

  • Direct secure messaging: kspyratos373196@direct.myadvocateaurora.org

Organizations & group practices 7

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 6

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1780203901",
    "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": "800-326-2250"
        },
        {
            "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": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154330",
            "country_code": "US",
            "telephone_number": "414-649-6000",
            "fax_number": "414-647-5940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530818426",
            "country_code": "US",
            "telephone_number": "920-802-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPYRATOS",
        "first_name": "KRISOS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81219",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "WI",
            "license": "81219-21",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "WI",
            "license": "81219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247993",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kspyratos373196@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3400 Union Ave",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530818426",
            "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": "3400 Union Ave",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530818426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.