Individual provider Active NPI

Eric S. Malicky, M.D.

  • Orthopaedic Surgery Physician
  • Grafton, WI
National Provider Identifier
1790715977
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
39848 Issued in WI
Practice address
975 Port Washington Rd
Grafton, WI 53024-9201
Phone
(262) 329-8300
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 39848 WI Primary

Addresses

Primary practice location

975 Port Washington Rd
Grafton, WI 53024-9201

Mailing address

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

Other practice location 1

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Other identifiers 2

IdentifierTypeStateIssuer
32437000MedicaidWI
P00452795OtherWIRR MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address emalicky658@direct.myadvocateaurora.org

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
I20060120000840 WI Practitioner - Orthopedic Surgery 5991786840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

Hospital & facility affiliations

  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038
  • Aurora Medical Center Sheboygan County Hospital, Sheboygan, WI, CCN 520035

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue21
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39848WIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Orthopaedic Surgery CurrentSince Jan 1, 2008 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2008 Accepting new patients
Advanced Healthcare SC Orthopaedic Surgery Past Accepting new patients

Locations

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

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

975 Port Washington Rd
Ste 110
Grafton, WI 53024
Phone (262) 329-1000

215 Washington St
Grafton, WI 53024
Phone (262) 375-3700

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

7878 N 76th St
Milwaukee, WI 53223
Phone (414) 354-6434

Organizations & group practices 3

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 5

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1790715977",
    "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": "975 PORT WASHINGTON RD",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249201",
            "telephone_number": "262-329-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 W Good Hope Rd",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532092042",
            "country_code": "US",
            "telephone_number": "414-352-3100",
            "fax_number": "414-247-4597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALICKY",
        "first_name": "ERIC",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "39848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32437000",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00452795",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3003 W Good Hope Rd",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532092042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emalicky658@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "3003 W Good Hope Rd",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532092042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grafton, WI

Sources for this page

Verify at the official NPI Registry.