Archebald J Pequet, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25498 Issued in WI

Practice address

1111 Delafield St
Ste 209
Waukesha, WI 53188-3417

Phone

(262) 542-0444

Fax

(262) 542-8214

NPI assigned

Sep 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: apequet20680@direct.phci.org

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.

• Moreland Medical Center

  • Clinical Medical Laboratory
  • Waukesha, WI
  • NPI 1447248182
  NPD (past)
• Prohealth Medical Group Inc

  • Family Medicine Physician
  • Waukesha, WI
  • NPI 1790720613
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1952398521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "STE 209",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883403",
            "telephone_number": "262-542-0444",
            "fax_number": "262-542-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 DELAFIELD ST",
            "address_2": "STE 209",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531883417",
            "telephone_number": "262-542-0444",
            "fax_number": "262-542-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEQUET",
        "first_name": "ARCHEBALD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WI",
            "license": "25498",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "25498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30716900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Pellmann, M.A., LMFT
• Zoe Penczykowski
• Raelee Penzi
• Kayla Mae Peplinski, MS, RD, LPC-IT
• Beth Maree Peppler
• Bery Perez
• Francisco Perez, M.D.
• Tina Marie Perez
• Jeffrey Michael Perinovic, RN
• Lauren M Perow-Krieg, AGACNP-BC

• Surgery Physician in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.