Active NPI
John Paul Korducki
- Emergency Medicine Physician
- Mount Pleasant, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 81209-20
- Practice address
- 13250 Washington Ave
Mount Pleasant, WI 53177-1516 - Phone
- (262) 799-8700
- NPI assigned
- Apr 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 81209-20 | WI | Primary |
Addresses
Primary practice location
13250 Washington Ave
Mount Pleasant, WI 53177-1516
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Other practice location 1
1211 Medical Center Dr
Nashville, TN 37232-0004
Phone (615) 322-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100239187 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jkorducki201756@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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Medical College of Wisconsin, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
13250 Washington Ave
Mount Pleasant, WI 53177-1516
Phone (262) 884-4000
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 81209-20 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients |
Locations
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
13250 Washington Ave
Mount Pleasant, WI 53177
Phone (262) 799-8330
Interoperability endpoints
- jkorducki201756@direct.myadvocateaurora.org
Organizations & group practices 2
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.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kenosha, WI
- NPI 1225156888
-
- General Acute Care Hospital
- Marinette, WI
- NPI 1043397177
-
dba Aurora Medical Center Bay Area Clinical Medical Laboratory
- Clinical Medical Laboratory
- Marinette, WI
- NPI 1083791115
Hospital
-
dba Aurora Medical Center Bay Area
- Land Ambulance
- Marinette, WI
- NPI 1427135557
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1851910772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13250 WASHINGTON AVE",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "531771516",
"telephone_number": "262-799-8700"
}
],
"practiceLocations": [
{
"address_1": "1211 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372320004",
"country_code": "US",
"telephone_number": "615-322-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KORDUCKI",
"first_name": "JOHN",
"middle_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-10",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "81209-20",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100239187",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jkorducki201756@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "13250 Washington Ave",
"city": "Mount Pleasant",
"state": "WI",
"country_code": "US",
"postal_code": "531771516",
"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": "13250 Washington Ave",
"city": "Mount Pleasant",
"state": "WI",
"country_code": "US",
"postal_code": "531771516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mount Pleasant, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.