Andrew Kyle Alexander, M.D. – Pediatrics Physician

Key facts

NPI: 1780737155
Entity type: Individual (NPI type 1)
Primary specialty: Pediatrics Physician 208000000X
License: 50089 (WI)
Practice address: 2253 W Mason St
Green Bay, WI 54303-4706
Phone: (920) 327-7300
NPI assigned: Jan 19, 2007
Sex: Male
Sole proprietor: No

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.

Aurora Medical Group, Inc. Certified Registered Nurse Anesthetist · Milwaukee, WI · NPI 1427271378

Medicare reassignment NPD WI
Aurora Medical Group, Inc. Durable Medical Equipment & Medical Supplies · Oshkosh, WI · NPI 1326858044

NPD
Aurora Medical Group, Inc. Mental Health Clinic/Center (Including Community Mental Health Center) · Milwaukee, WI · NPI 1659599157

NPD
Aurora Medical Group, Inc. Durable Medical Equipment & Medical Supplies · Manitowoc, WI · NPI 1801941075

NPD (past)
Baycare Aurora, LLC General Acute Care Hospital · Green Bay, WI · NPI 1255387726

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in WI
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
I20080711000282	WI	Practitioner - Pediatric Medicine	4981776739	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

Practice roles

Organization	Status	New patients
Aurora Medical Group, Inc.	Current	Accepting new patients
Aurora Medical Group, Inc.	Current since Dec 28, 2009	Accepting new patients
Aurora Medical Group, Inc.	Current since Dec 28, 2009	Accepting new patients
Baycare Aurora, LLC	Past	Accepting new patients
Aurora Medical Group, Inc.	Past	Accepting new patients

Locations

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

123 N Military Ave
Green Bay, WI 54303
Phone (920) 494-3421

2253 W Mason St
#200
Green Bay, WI 54303
Phone (920) 327-7300

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

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pediatrics Physician	208000000X	50089	WI	Yes

Addresses

Primary practice location

2253 W Mason St
Green Bay, WI 54303-4706

Mailing address

2253 W Mason St
Green Bay, WI 54303-4706
Phone (920) 327-7300

Other identifiers

Identifier	Type	State	Issuer
35296600	Medicaid	WI
50089-20	Other	WI	WI LICENSE

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	aalexander57621@direct.myadvocateaurora.org	Direct
FHIR URL	https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Other providers in Green Bay, WI

All providers in Green Bay, WI · Pediatrics 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 Nov 18, 2021. 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.

Verify at the official NPI Registry.