NPIMap

Organization Active NPI

Alfred J Wroblewski MD PC

  • Orthopaedic Surgery Physician
  • Petoskey, MI
National Provider Identifier
1821252289
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
069568 Issued in MI
Legal business name
ALFRED J WROBLEWSKI MD PC
Doing business as
Alfred J Wroblewski MD PC
Practice address
630 W Mitchell St Ste 4
Petoskey, MI 49770-2214
Phone
(231) 348-4005
Fax
(833) 973-5899
NPI assigned
Jul 15, 2008
Last updated
Oct 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Kimberly Gaye Wroblewski
Title
Administrator
Phone
(231) 348-4005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 069568 MI Primary

Addresses

Primary practice location

630 W Mitchell St Ste 4
Petoskey, MI 49770-2214

Mailing address

630 W Mitchell St Ste 4
Petoskey, MI 49770-2214
Phone (231) 348-4005

Other identifiers 2

IdentifierTypeStateIssuer
200B400120OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
4081820MedicaidMI

Other names 1

  • ALFRED J WROBLEWSKI MD PC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061005000190 MI Part B Supplier - Clinic/Group Practice 6709882384 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: St Ignance, MI; Saint Ignance, MI; Petoskey, MI; Charlevoix, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

630 W Mitchell St
Ste 4
Petoskey, MI 49770
Phone (231) 348-4005

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1821252289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W MITCHELL ST STE 4",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702214",
            "telephone_number": "231-348-4005",
            "fax_number": "833-973-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MITCHELL ST STE 4",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702214",
            "telephone_number": "231-348-4005",
            "fax_number": "833-973-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALFRED J WROBLEWSKI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "WROBLEWSKI",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "GAYE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "231-348-4005"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "069568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "200B400120",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4081820",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALFRED J WROBLEWSKI MD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.