Baycare Aurora Kaukauna Surgery Center LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Kaukauna, WI
NPI 1821614710 · NPPES record last updated Oct 3, 2025
Key facts
- NPI
- 1821614710
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- BAYCARE AURORA KAUKAUNA SURGERY CENTER LLC
- Practice address
- 1500 Arbor Way
Kaukauna, WI 54130 - Phone
- (920) 372-7150
- NPI assigned
- Jun 17, 2020
- Organization subpart
- No
Authorized official
- Name
- Kara Richardson
- Title
- Assistant Treasurer
- Phone
- (704) 631-0450
Member of 2
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Baycare Aurora Kaukauna Surgery Center
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0990994 | A2Cl-Aurora Baycare Medical Center - Kaukauna | Compliance | Jul 20, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201021002532 | WI | Part B Supplier - Ambulatory Surgical Center | 2961822408 | Practice locations: Kaukauna, WI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
1500 Arbor Way
Kaukauna, WI 54130
Mailing address
3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 647-6326
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100152368 | Medicaid | WI |
Other names
- Kaukauna Surgery Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Kaukauna, WI
- Aurora Medical Group, Inc.
- Aurora Pharmacy Inc
- Molly Marie Barrett
- Deanna Lea Baughman
- Jennifer Lea Baumgart
- Baycare Aurora, LLC
- Baycare Clinic, LLP
- Heather A Beaudoin
- Bio-Medical Applications of Wisconsin, Inc.
- Maureen R Birk
All providers in Kaukauna, WI · Ambulatory Surgical Clinic/Center in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.