John P. Modrzynski, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23162 Issued in WI

Practice address

N2934 State Road 22
Wautoma, WI 54982-5267

Phone

(920) 787-4613

Fax

(920) 787-5433

NPI assigned

Feb 7, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Locations

Interoperability endpoints

• Direct secure messaging: jmodrzynski120087@direct.thedacare.org

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.

• Thedacare, Incorporated

  dba ThedaCare Physicians

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1962475434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-787-4613",
            "fax_number": "920-787-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N2934 STATE ROAD 22",
            "city": "WAUTOMA",
            "state": "WI",
            "postal_code": "549825267",
            "telephone_number": "920-787-4613",
            "fax_number": "920-787-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N2034 Highway 22",
            "address_purpose": "LOCATION",
            "city": "Wautoma",
            "state": "WI",
            "postal_code": "54982",
            "country_code": "US",
            "telephone_number": "920-787-4613",
            "fax_number": "920-787-5433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "N2034 Highway 22",
            "address_purpose": "LOCATION",
            "city": "Wautoma",
            "state": "WI",
            "postal_code": "54982",
            "country_code": "US",
            "telephone_number": "920-787-4613",
            "fax_number": "920-787-5433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MODRZYNSKI",
        "first_name": "JOHN",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "23162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianne L Martinez, PTA
• Cynthia Marie McMahon
• Karen E McQuown, DENTAL HYGIENIST
• Brian L Meckelberg, OD
• Kayla Meilick, RDH
• Bonnie Sue Monaghan, RDH
• Virginia Ellen Moon, M.S.
• Toni Ann Morgan-Jones, PHD
• Renee Murphy, MD
• Emily Nault

• Family Medicine Physician in Wautoma, WI
• Providers in Wautoma, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.