Cory Ryan Dubose, D.O.

Primary specialty

Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X

License

67295 Issued in WI

Practice address

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330

Phone

(414) 649-6000

NPI assigned

Feb 20, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

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

Specialty

Undersea and Hyperbaric MedicineAlso: Family Practice

Education

West Virginia School of Osteopathic Medicine, 2013

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)

Hospital & facility affiliations

• Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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 Care Compare group NPD
• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1003861188
  Medicare reassignment NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD
• 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)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Aurora Health Care Metro, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cudahy, WI
  • NPI 1235355983

  Hospital

  Care Compare affiliation
• Aurora Health Care Metro, Inc.

  • General Acute Care Hospital
  • Milwaukee, WI
  • NPI 1861447179
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1811356736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W KINNICKINNIC RIVER PKWY STE 309",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153660",
            "telephone_number": "414-385-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 W OKLAHOMA AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154330",
            "telephone_number": "414-649-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "CORY",
        "middle_name": "RYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-20",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "WI",
            "license": "67295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100055842",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdubose188995@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "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": "2900 W Oklahoma Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ella Dublin, PA-C
• Holly Dubois, RD
• Jessica Marie Dubois
• Melissa Sue Dubois, MD
• Kelly A Dubord, LPC
• Haley A Dubose, NP
• Katsiaryna Dubrouskaya, DO
• Seth M Dubry, MD
• James C Ducanto, MD
• Elizabeth Duchac, RD

• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Undersea and Hyperbaric Medicine (Preventive Medicine) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.