Individual provider Active NPI

Triton J Krizenesky, MD

  • Internal Medicine Physician
  • De Pere, WI
National Provider Identifier
1962063834
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
80029-20 Issued in WI
Practice address
1800 Lawrence Dr
De Pere, WI 54115-9108
Phone
(920) 983-3220
Fax
(920) 983-3226
NPI assigned
Jun 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125073840 IL
Internal Medicine Physician 207R00000X 80029-20 WI Primary

Addresses

Primary practice location

1800 Lawrence Dr
De Pere, WI 54115-9108

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222

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
I20220701001057 WI Practitioner - Internal Medicine 9830423375 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1800 Lawrence Dr
De Pere, WI 54115-9108
Phone (920) 983-3220

Hospital & facility affiliations

  • Bellin Home Health Agency Home health agency, Green Bay, WI, CCN 527089
  • Unity Hospice Hospice, De Pere, WI, CCN 521503
  • Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
  • Rennes Health and Rehab Center-De Pere Nursing home, De Pere, WI, CCN 525573

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 Medicine

State licenses

LicenseStateTypeSpecialty
125073840ILMDInternal Medicine Physician
80029-20WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Internal Medicine CurrentSince Jun 27, 2022 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Jun 1, 2024 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jun 27, 2022 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

1800 Lawrence Dr
De Pere, WI 54115
Phone (920) 983-3220

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Interoperability endpoints

  • Direct secure messaging: tkrizenesky323549@direct.thedacare.org
  • Direct secure messaging: tkrizenesky924473@direct.emplifyhealth.org

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 4

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": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1962063834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LAWRENCE DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159108",
            "telephone_number": "920-983-3220",
            "fax_number": "920-983-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIZENESKY",
        "first_name": "TRITON",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-21",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125073840",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "80029-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.