Kenosha Hand & Plastic Surgery SC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

33466020 Issued in WI

Legal business name

KENOSHA HAND & PLASTIC SURGERY SC

Practice address

10117 74TH St Ste 100
Kenosha, WI 53142-7542

Phone

(262) 656-8237

Fax

(622) 453-0882

NPI assigned

Jan 10, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Michael Birndorf, MDNPI 1881604049

Title

Owner

Phone

(262) 656-8237

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Birndorf, MD

  • Surgery of the Hand (Plastic Surgery) Physician
  • Kenosha, WI
  • NPI 1881604049
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1912329905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 8TH AVE # 104",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435031",
            "telephone_number": "262-656-8237",
            "fax_number": "262-671-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10117 74TH ST STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427542",
            "telephone_number": "262-656-8237",
            "fax_number": "622-453-0882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENOSHA HAND & PLASTIC SURGERY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "BIRNDORF",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-656-8237",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "33466020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31835100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenosha Digestive Health Center LLC
• Kenosha Emergency Physicians, LLC
• Kenosha Family Dentistry
• Kenosha Family Practice, S.C.
• Kenosha Family Vision Care LLC (Regner Family Vision Clinic)
• Kenosha Hearing Aid Centers
• Kenosha Human Development Services, Inc
• Kenosha Human Development Services, Inc
• Kenosha Kidney Dialysis LLC
• Kenosha Oral Surgery, S.C.

• Plastic Surgery Physician in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Plastic Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.