David J Pencikowski, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3008-33 Issued in WI

Practice address

3611 S Chicago Ave
South Milwaukee, WI 53172-3738

Phone

(414) 762-2450

NPI assigned

Nov 29, 2006

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dpencikowski55442@direct.myadvocateaurora.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.

• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD (past)
• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Oconto, WI
  • NPI 1699926964
  NPD (past)
• Upper Peninsula Association of Rural Health Services, Inc.

  • Family Medicine Physician
  • Marquette, MI
  • NPI 1396851804
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1962579243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 S CHICAGO AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531723738",
            "telephone_number": "414-762-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 S CHICAGO AVE",
            "city": "SOUTH MILWAUKEE",
            "state": "WI",
            "postal_code": "531723738",
            "telephone_number": "414-762-2450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 Liebman Ct",
            "address_2": "APT 8",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543025090",
            "country_code": "US",
            "telephone_number": "999-999-9999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENCIKOWSKI",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "3008-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpencikowski55442@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3611 S Chicago Ave",
            "city": "South Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531723738",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3611 S Chicago Ave",
            "city": "South Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531723738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dixie M. Patel, M.D.
• Vikas Patel
• Mansi Pathak
• PDN
• Anna Michelle Pearson
• Steven Christopher Penn
• Larry John Pleva, P.T.
• Jacqueline Lee Polakowski, COTA
• Potisk Chiropractic Office, S.C.
• Thomas Potisk, DC

• Nurse Practitioner in South Milwaukee, WI
• Providers in South Milwaukee, WI by specialty
• Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.