NPIMap

Individual provider Active NPI

Paul Mihalakakos, MD

  • Anesthesiology Physician
  • Two Rivers, WI
National Provider Identifier
1790877082
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
43260 Issued in WI
Practice address
5300 Memorial Dr
Two Rivers, WI 54241-3923
Phone
(920) 793-7300
NPI assigned
Sep 28, 2006
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 43260 WI Primary

Addresses

Primary practice location

5300 Memorial Dr
Two Rivers, WI 54241-3923

Mailing address

602 Wild Oak Dr
Manitowoc, WI 54220-9050
Phone (920) 652-0654

Other identifiers 1

IdentifierTypeStateIssuer
34085200MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address pmihalakakos54544@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414000868 WI Practitioner - Anesthesiology 8224022926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Creighton University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

5000 Memorial Dr
Two Rivers, WI 54241-3900
Phone (920) 794-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43260WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 16, 2001 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 16, 2001 Accepting new patients
Aurora Health Care North, Inc. CurrentSince Nov 1, 2003 Accepting new patients

Locations

601 Reed Ave
Manitowoc, WI 54220
Phone (920) 682-8841

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

5000 Memorial Dr
Two Rivers, WI 54241
Phone (920) 794-5000

5300 Memorial Dr
Two Rivers, WI 54241
Phone (920) 793-7300

Interoperability endpoints

  • Direct secure messaging: pmihalakakos54544@direct.myadvocateaurora.org

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aurora Health Care Metro, Inc.Milwaukee, WI, CCN 520138 Hospital Corporate Director Apr 16, 2025
Aurora West Allis Medical CenterWest Allis, WI, CCN 520139 Hospital Corporate Director Jan 1, 2025
Aurora Lakeland Medical CenterElkhorn, WI, CCN 520102 Hospital Corporate Director Apr 16, 2025
Aurora Health Care Metro, Inc.Milwaukee, WI, CCN 52T138 Hospital Corporate Director Apr 16, 2025

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1790877082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 WILD OAK DR",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542209050",
            "telephone_number": "920-652-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542413923",
            "telephone_number": "920-793-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHALAKAKOS",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "43260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34085200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmihalakakos54544@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5300 Memorial Dr",
            "city": "Two Rivers",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542413923",
            "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": "5300 Memorial Dr",
            "city": "Two Rivers",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542413923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Two Rivers, WI

Sources for this page

Verify at the official NPI Registry.