Individual provider Active NPI

Kaleen D Puccetti, MD

  • Diagnostic Radiology Physician
  • Thiensville, WI
National Provider Identifier
1831545094
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
69881 Issued in WI
Practice address
10945 N Port Washington Rd
Thiensville, WI 53092-5078
Phone
(262) 292-3151
NPI assigned
May 6, 2016
Last updated
Feb 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 69881 WI Primary

Addresses

Primary practice location

10945 N Port Washington Rd
Thiensville, WI 53092-5078

Mailing address

PO Box 713121
Chicago, IL 60677-0321
Phone (262) 292-3151

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5511

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220608001553 WI Practitioner - Diagnostic Radiology 1355634734 Reassigns benefits to 16 organizations
I20240304000688 IL Practitioner - Diagnostic Radiology 1355634734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Pennsylvania State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marshfield Clinic IncGroup PAC ID 2264345206, 207 clinicians
Milwaukee Radiologists LTDGroup PAC ID 7113915810, 16 clinicians
Premier Radiology Wisconsin LLCGroup PAC ID 9537595533, 111 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

10101 S 27TH St
Franklin, WI 53132-7209
Phone (414) 325-4700

10180 Washington Ave
Mount Pleasant, WI 53177-1604
Phone (414) 973-7830

3501 Golf Rd
Eau Claire, WI 54701-8028
Phone (715) 858-4200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69881WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Feb 3, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Flambeau Hospital Inc Current Accepting new patients
Precision Radiology - Illinois LTD CurrentSince Dec 1, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Feb 3, 2025 Accepting new patients
Memorial Hospital Inc CurrentSince Feb 3, 2025 Accepting new patients
Medical Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Feb 1, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Feb 3, 2025 Accepting new patients
DRS. Massaro & Kalenak S C Current Accepting new patients
Wisconsin Radiology Specialists, S C CurrentSince Jul 18, 2023 Accepting new patients
Milwaukee Radiologists LTD Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jul 1, 2022 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Flambeau Hospital Inc CurrentSince Feb 3, 2025 Accepting new patients
Marshfield Clinic Inc CurrentSince Feb 3, 2025 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince Sep 23, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Feb 3, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Feb 3, 2025 Accepting new patients

Locations

39856 Treasury Ctr
Chicago, IL 60694

7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

3111 W Rawson Ave
Franklin, WI 53132
Phone (414) 325-4300

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

6150 W Layton Ave
Ste 110
Greenfield, WI 53220
Phone (414) 761-8346

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

6150 W Layton Ave
Milwaukee, WI 53220

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

10945 N Port Washington Rd
Ste 201
Thiensville, WI 53092
Phone (262) 478-0301

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

3077 N Mayfair Rd
Ste 115
Wauwatosa, WI 53222
Phone (414) 847-1800

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/67ff075a-8289-4f2d-a8eb-5dc1f0d954ab/

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 7

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": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1831545094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713121",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770321",
            "telephone_number": "262-292-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD",
            "city": "THIENSVILLE",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "262-292-3151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N OAK AVE",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "54449",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCCETTI",
        "first_name": "KALEEN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "69881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N OAK AVE",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thiensville, WI

Sources for this page

Verify at the official NPI Registry.