Individual provider Active NPI

Michael D Plotkin, DO

  • Family Medicine Physician
  • Brown Deer, WI
National Provider Identifier
1881636819
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
39967 Issued in WI
Practice address
9233 N Green Bay Rd
Brown Deer, WI 53209-1103
Phone
(414) 270-8150
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39967 WI Primary

Addresses

Primary practice location

9233 N Green Bay Rd
Brown Deer, WI 53209-1103

Mailing address

4425 N Port Washington Rd
Attn: Clinic Credentialing
Glendale, WI 53212-1082
Phone (414) 270-8150

Other identifiers 1

IdentifierTypeStateIssuer
30097900MedicaidWI

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129000536 WI Practitioner - Family Practice 4789587585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2350 N Lake Dr
Milwaukee, WI 53211-4528

801 S 70TH St
West Allis, WI 53214-3147
Phone (414) 773-6600

9252 N Green Bay Rd
FL 2
Brown Deer, WI 53209-1104
Phone (414) 270-8150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39967WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Mar 18, 2001 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Current Accepting new patients
The Medical College of Wisconsin, Inc. Family Medicine CurrentSince Oct 7, 2004 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Mar 18, 2001 Accepting new patients
Mosaic Family Health, Inc Family Medicine CurrentSince Jun 1, 2018 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc Family Medicine Past Accepting new patients

Locations

229 S Morrison St
Appleton, WI 54911
Phone (920) 832-2783

100 N Oneida St
Appleton, WI 54911
Phone (920) 832-2783

N112W15415 Mequon Rd
Germantown, WI 53022
Phone (262) 250-7800

4425 N Port Washington Rd
Glendale, WI 53212
Phone (414) 326-2218

6900 N Port Washington Rd
Glendale, WI 53217
Phone (414) 270-8100

400 W River Woods Pkwy
Glendale, WI 53212
Phone (414) 465-3000

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

9252 N Green Bay Rd
Fl 2
Milwaukee, WI 53209
Phone (414) 270-8150

1317 W Grand Ave
Prt Washingtn, WI 53074
Phone (262) 268-6998

1320 Wisconsin Ave
Racine, WI 53403
Phone (262) 687-2222

1414 N Taylor Dr
Ste 210
Sheboygan, WI 53081
Phone (262) 243-2500

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

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1881636819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 N PORT WASHINGTON RD",
            "address_2": "ATTN: CLINIC CREDENTIALING",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532121082",
            "telephone_number": "414-270-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9233 N GREEN BAY RD",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532091103",
            "telephone_number": "414-270-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOTKIN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "39967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30097900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brown Deer, WI

Sources for this page

Verify at the official NPI Registry.