NPIMap

Individual provider Active NPI

David J Palubiak, MD

  • Nephrology Physician
  • Green Bay, WI
National Provider Identifier
1871596627
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
45699 Issued in WI
Practice address
2020 Riverside Dr
Suite 200
Green Bay, WI 54301-2300
Phone
(920) 433-9920
Fax
(920) 433-9927
NPI assigned
May 24, 2005
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 45699 WI Primary

Addresses

Primary practice location

2020 Riverside Dr
Suite 200
Green Bay, WI 54301-2300

Mailing address

2020 Riverside Dr
Suite 200
Green Bay, WI 54301-2300
Phone (920) 433-9920

Other identifiers 1

IdentifierTypeStateIssuer
34438500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000499 WI Practitioner - NephrologyPractitioner - Internal Medicine 4981507209 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, shared by 16 NPIs, 593 clinicians
St Clare Memorial Hospital, IncGroup PAC ID 0446211395, 62 clinicians

Practice addresses (Care Compare)

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone (920) 498-4200

855 S Main St
Suite 1
Oconto Falls, WI 54154-1241
Phone (920) 846-8187

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45699WIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Oct 11, 2009 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Current Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Oct 11, 2009 Accepting new patients
Prevea Clinic, Inc. Current Accepting new patients
St. Clare Memorial Hospital, Inc CurrentSince Mar 1, 2019 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Feb 9, 2022 Accepting new patients
Prevea Clinic, Inc. CurrentSince Jan 26, 2006 Accepting new patients
St Mary's Hospital Medical Center of Green Bay Inc.-Hospital Sisters CurrentSince Jun 1, 2014 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jun 1, 2014 Accepting new patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Feb 9, 2022 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Mar 1, 2019 Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

2020 Riverside Dr
Ste 200
Green Bay, WI 54301
Phone (920) 433-9920

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

Interoperability endpoints

  • Direct secure messaging: dpalubiak27567@ewd.direct.hshs.org

Organizations & group practices 11

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.

Hospital & facility affiliations 12

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1871596627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 RIVERSIDE DR",
            "address_2": "SUITE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012300",
            "telephone_number": "920-433-9920",
            "fax_number": "920-433-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RIVERSIDE DR",
            "address_2": "SUITE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012300",
            "telephone_number": "920-433-9920",
            "fax_number": "920-433-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALUBIAK",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WI",
            "license": "45699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34438500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.